On August 7, 2020, Michigan resident Collyer Smith filed a class action lawsuit against Golden Rule Insurance Company. The lawsuit is an attempt to halt the health insurer’s practice of presumptively denying claims for coverage of urine analysis drug testing and other services provided by outpatient drug treatment centers.
Medically Necessary Services Denied
Smith alleges that both the urine analysis testing and outpatient drug treatments are critical and medically necessary components of any treatment plan for insureds with a history of substance abuse. For an insured to receive effective substance abuse treatment, it is essential that providers know whether and what drugs are being used and that the insured has access to an outpatient treatment facility.
Smith also alleges that Golden Rule breached its health insurance contract with Smith and the proposed class members by failing to follow its own promise to cover “medically necessary” services. The insurance provider also violated the federal Mental Health Parity and Addiction Equity Act, which is incorporated as a matter of law in each of its insurance contracts.
Smith’s claims originated when Golden Rule refused to cover urine analysis drug testing and outpatient drug treatment for his son, who later died of a drug overdose. The case, which is styled Collyer Smith v. Golden Rule Insur. Co., et al., Case No. 1:20-cv-2066, is currently pending in the United States District Court for the Southern District of Indiana (Indianapolis Division). Smith is represented by Greg Coleman Law PC, Jordan Lewis P.A., Delaney & Delaney LLC, Crueger Dickinson LLC, and Wallace Wexler LLP.
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