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CSWA - Mental Health Parity Implementation in California -11-3-20

04 Nov 2020 12:24 PM | CSWA Administrator (Administrator)

I am delighted to inform you that the Federal Court which made the ruling in Wit v. United Behavioral Health in March of 2019 has issued further remedies for the implementation of this ruling today. This ruling was consolidated with Alexander et al. v. United Behavioral Health, another case which found UBH in violation of mental health parity laws nationally and in California. The court explained in the 99-page document the need for the following steps:

  1. a 10-year injunction requiring UBH to exclusively apply medical necessity criteria developed by non-profit clinical specialty associations;
  2. appointment of a special master;
  3. training of UBH in the proper use of court-ordered medical necessity criteria; and
  4. reprocessing of nearly 67,000 mental health and substance use disorder benefit claims denied during the class period.

The remedies only apply to self-insured plans that fall under the Employee Retirement Income Security Act of 1974 (ERISA). It does not apply to government employees or commercial insurance plans.

Nonetheless, this implementation of the Wit ruling is as a major success for fully implementing mental health parity for the 50,000 ERISA enrollees in California and serves as a guide for laws in other states which have not fully implemented mental health parity laws.

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