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Law360: Matt Lavin on UnitedHealth Court Ordered Process

August 6, 2021

Source: Law360

Napoli Shkolnik PLLC partner Matthew Lavin, who represents patients who have been denied insurance coverage for mental health treatment, said the feedback he’s gotten from “hundreds of clients” is that UBH still isn’t fully covering substance abuse treatment.

Under UBH’s current guidelines, developed by the American Society of Addiction Medicine, it should cover multiple types of addiction treatment: detox, residential treatment, partial hospitalization and outpatient care, Lavin said. But he’s seen over and over again that the insurer is skipping steps, he said.

“For many years, the insurers and providers were playing the same game but using different rule books,” Lavin said. “The ASAM guidelines are actually what’s used in a clinical setting by providers across the country, and now insurers are using the same guidelines. Hopefully it’ll lead to … better outcomes, people getting the treatment they need.”

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