November 28, 2021

Volume XI, Number 332

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Recent District Court Decision Highlights the Importance of Adequate Behavioral Health Claims Processing Guidelines for ERISA Plans [PODCAST]

On this week’s episode, Carla DewBerry and Sarah Carlins discuss a recent California Federal District Court decision in David Wit v. United Behavioral Health, in which the court found that the defendant insurer violated ERISA by improperly denying behavioral health claims submitted by over fifty thousand beneficiaries. The presenters discuss the ways in which the insurer’s inadequate internal guidelines for the processing of behavioral health treatment claims led to the decision, and what this might mean for the design of behavioral health claims processing guidelines under ERISA regulated health plans in the future.

Copyright 2021 K & L GatesNational Law Review, Volume X, Number 346
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About this Author

Carla DewBerry Healthcare and Corporate Tax Attorney K&L Gates Law Firm Seattle
Partner

Carla DewBerry practices in the areas of health care law; mergers and acquisitions; and federal, state and local tax. Carla represents health care clients in Medicare and Medicaid reimbursement matters, including related audits and litigation. In addition, she is an experienced tax and business counselor and represents clients in corporate restructurings, joint venture operations, licensing, and federal and state taxation matters. She provides counsel for clients outside the health care industry as well.

Carla's experience includes working as a...

206.370.8317
Sarah L. Carlins Health Care K&L Gates Pittsburgh, PA
Of Counsel

Sarah Carlins is of counsel at the firm’s Pittsburgh office. She is a member of the health care practice group.

Primary Practice

  • Health Care

Secondary Practices

  • Health Care Fraud and Abuse (U.S.)

412.355.6548
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