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.

  • Apytele@sh.itjust.worksEnglish
    16·
    6 days ago

    Also executive dysfunction (fancy word for the motivation and planning it takes to do complex tasks like navigating bureaucracy) is a symptom of pretty much every mental illness ever making them the easiest population to collect a premium from then bury in paperwork and by doing so never actually have to pay out for services. When you add in having the government cut a check perr poor person to insurance companies to provide state benefits it basically becomes an infinite money glitch that churns faster the more people you force into poverty.

    • NycterVyvver@lemmy.worldEnglish
      6·
      6 days 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·
        5 days 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.