FOR IMMEDIATE RELEASE
November 17, 1999

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(Washington, DC) - The American Psychological Association (APA) today strongly denounced the reported exclusion of mental health services from UnitedHealth Group?s (UHG) recent decision to give doctors the final say on what care is medically necessary. "Any policy that eliminates utilization review for medical but not behavioral health services is nothing but blatant, indefensible discrimination against people with mental health disorders," says Russ Newman, Ph.D., J.D., the APA?s executive director for professional practice.

UHG is one of the largest managed care companies in the United States. Under the new UHG policy, providers treating patients for physical conditions will no longer be required to obtain United?s permission before proceeding with covered services. By contrast, recent press statements from company executives rejected the change in policy for mental health and substance abuse services delivered through UHG?s subsidiary known as United Behavioral Health (UBH). Mental health professionals? decisions about necessary patient care would continue to be subject to preauthorization and overruling by UBH representatives.

UBH officials reportedly have attempted to justify this discriminatory treatment of mental health care by portraying it as "more intangible" than medical care. "Despite what UBH would lead the public to believe, mental health treatment is no less legitimate, no less valuable, and no less tangible than medical treatment," says Dr. Newman.

In fact, treatment of mental health disorders today is at least as successful as treatment of general medical conditions. Major depression, for example, is treated successfully in 80 percent of patients, whereas adult onset diabetes (type 2) is treated successfully by insulin therapy at a lower rate. Yet, by continuing to require utilization review for mental health services, UBH could challenge a doctor?s treatment of depression while the parent company would not challenge a doctor?s treatment of diabetes.

"A decision to continue utilization review for mental health but not medical services flies in the face of this country?s move toward parity and toward ending discrimination against people with mental health disorders," said Dr. Newman.

Dr. Newman also cautions that UHG?s decision to eliminate utilization review for medical claims may not be the panacea that many patients and providers are seeking to remedy the ills of market-driven treatment decision making by managed care entities. It appears that retrospective and concurrent utilization review will still be available to UHG, which could result in services being provided but healthcare professionals not being paid. "In addition, it will not necessarily stop companies like UHG from rationing care inappropriately through a variety of means common to the managed care industry," Dr. Newman warns. Eliminating utilization review will do nothing to prevent companies from using provider profiling, for example, to identify and terminate doctors whose practice patterns are inconsistent with the company?s financial criteria for determining treatment.