On May 13, 2022, an Amicus Brief authored by Mark DeBofsky was submitted to the U.S. Court of Appeals for the Ninth Circuit in support of a petition for rehearing filed by the Plaintiffs-Appellees in the case of Wit v. United Behavioral Health. The Brief provided the Court with additional arguments in favor of upholding the landmark lower court rulings that found United Behavioral Health had improperly denied over 67,000 class action plaintiffs’ claims for outpatient, intensive outpatient, and residential behavioral health treatment. The keystone to the lower court’s ruling was its finding that health insurers must provide coverage for medically necessary treatment that is consistent with generally accepted standards of care established in the form of treatment guidelines issued by authoritative mental health treatment organizations and the use of which are mandated by several states.

The amicus brief pointed out that the appellate ruling overturning the district court’s decisions gave insurers too much discretionary authority to dictate or withhold treatment, and that the societal consequences would exacerbate an already worsening mental health crisis in the United States. The amicus brief argued that health insurers should not be permitted to allow financially-influenced treatment authorization decisions to impede medically necessary care aimed at long-term patient recovery.

The behavioral healthcare advocacy organizations and authorities represented in the Amicus Brief include:

The brief described the mission of each of those esteemed organizations and their interest in an outcome that favors better mental health disability treatment consistent with what the mental health treatment community has established as generally accepted standards of behavioral healthcare.

The most important finding from the perspective of amici is that the panel Case ruling slammed shut the door to patient access to safe and effective, and treatment for behavioral health and substance use disorders and sets a dangerous precedent for healthcare throughout this Circuit and the country.  It is reassuring that this appeal and the amici perspective took place during Mental Health Awareness Month.

You may access and download the full amicus brief here.

Download Mental Health Amicus Brief

Get your copy of the Wit vs. United Behavioral Health Appeal supporting Amicus Brief:

Get a Copy of the Brief

Related Articles

Courts Should Follow 8th Circ. On ERISA Procedure Rules

There is no provision in the Employee Retirement Income Security Act of 1974 mandating that claimants must exhaust internal appeals as a precondition to filing a lawsuit to challenge a claim denial. Nonetheless, most courts have required claimants to exhaust prelitigation appeals before their cases may be heard in court. […]

‘Full and Fair Review’ Required Insurer to Share Adverse Report With Claimant

‘Full and Fair Review’ Required Insurer to Share Adverse Report With Claimant

The ERISA statute, at 29 U.S.C. Sec. 1133, guarantees benefit claimants the right to a “full and fair review” of denied claims. To flesh out the meaning of what constitutes a full and fair review, the U.S. Department of Labor has issued a detailed set of regulations in 29 C.F.R. Sec. 2560.503-1 setting forth minimum standards plan administrators must meet. […]

All the Ways in Which a Disability Benefits Claim Appeal Can Go Wrong

All the Ways in Which a Disability Benefits Claim Appeal Can Go Wrong

You worked hard on your long term disability appeal.  Hopefully, you followed our LTD claim appeal best practices when preparing your appeal.  Maybe you followed our advice and hired an attorney to prepare the appeal for you.  Now, the appeal is in the insurer’s hands.  Despite your preparation, it is still possible for the appeal to go awry after it is submitted to the disability insurer. […]