The U.S. Department of Labor claims in a new lawsuit that a UnitedHealth Group unit illegally rejected emergency room care and urine drug screen claims for thousands of people.
UMR, Inc., a Wisconsin-based third-party administrator owned by UnitedHealth, manages benefits for more than 2,100 employee health plans. The federal government says the company denied ER visits and urine drug screens for years using a process that didn’t meet federal standards for health plans that employers fund themselves, known as self-insured plans. The standards are part of a law called the Employee Retirement Income Security Act, or ERISA.
“I see it as significant because the Department of Labor is actually looking under the hood at the standards and methods that insurers apply when they decide whether or not to approve or deny a claim,” said Colleen Medill, a professor at the University of Nebraska College of Law and nationally recognized legal scholar on ERISA. “They are looking at their process.”
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