NYAG and United Behavioral Health Outpatient Services Settlement Information
On August 11, 2021, the New York State Attorney General Letitia James (“NYAG”) filed a Complaint in the United States District Court for the Eastern District of New York alleging that United Behavioral Health and certain affiliates (“UBH”) violated the Mental Health Parity and Addiction Equity Act (“MHPAEA”) and provisions of New York law by: (i) reducing reimbursement for out-of-network psychotherapy services provided by non-physician therapists such as psychologists and social workers (“Tiered Reimbursement”); and (ii) employing an outlier management program for psychotherapy called Algorithms for Effective Reporting and Treatment (“ALERT”), which resulted in denials of coverage for psychotherapy services. On August 11, 2021, the NYAG and UBH settled the lawsuit. Although UBH has denied the NYAG’s allegations, under the settlement agreement, certain New York members will receive payment if they had claims that were reduced under Tiered Reimbursement or denied under ALERT from November 22, 2013 forward. These claims will be paid from Common Funds that will be managed by an Independent Administrator, who will contact people eligible for reimbursement. All questions regarding the settlement should be directed to the Independent Administrator, Rust Consulting, at 866-590-8527.