APA Can Take on Insurers on Behalf of Patients
U.S. appeals court rules New York State Psychiatric Associationn can bring claim on behalf of members, patients.
HealthDay News — A U.S. appeals court has ruled that medical associations have a legal standing to represent their members and members' patients in cases against health insurance companies, according to a report published by the American Medical Association.
The New York State Psychiatric Association (NYSPA) brought a class action lawsuit alleging violation of state and federal laws by United. United's practices were claimed to have been designed to create the illusion of impartiality and fairness, while undermining access to treatment for patients with mental health claims. United challenged the legal standing of the NYSPA to represent the interests of its members and members' patients.
The second U.S. Circuit Court of Appeals determined that NYSPA does have standing to represent its members. The results of this case will have implications for similar mental health cases, including a case in Connecticut in which the American Psychiatric Association is alleging that Anthem Health Plans failed to pay proper mental health and substance abuse benefits.
"At this stage in the litigation, it remains plausible that the participation of a limited number of NYSPA members will allow NYSPA to prove that United's practices violate the relevant statutes," the court wrote in its decision.
Read more on the decision here.