How UnitedHealth’s Playbook for Limiting Mental Health Coverage Puts Countless Americans’ Treatment at Risk
www.propublica.org
United used an algorithm system to identify patients who it determined were getting too much therapy and then limited coverage. It was deemed illegal in three states, but similar practices persist due to a patchwork of regulation.

Summary

UnitedHealth Group’s Optum subsidiary uses algorithms to identify patients and providers deemed to be receiving excessive mental health care, leading to reduced coverage and potential harm to patients.

Despite regulatory actions in some states, the company’s practices continue due to the lack of a unified regulatory oversight.

Mental health advocates argue that this fragmentation benefits insurance companies by allowing them to shift scrutinized practices to other jurisdictions.

  • NycterVyvver@lemmy.worldEnglish
    6·
    1 month ago

    Wow. I never considered executive functioning and neurodivergent related behaviors as predictable patterns for insurance companies to exploit, but you’re absolutely right.

    • Apytele@sh.itjust.worksEnglish
      1·
      1 month ago

      There’s been articles written about it actually. Google “health insurance ghost networks” for more info but the short version is that you know how the only utility of a middleman is to provide convenience? They get to keep more money every time you can’t figure out which doctors they actually cover. They actually get MORE money for being WORSE middlemen.