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.
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.