Upholding Generally Accepted Standards of Care: Strategies Informed by the Wit Case

The National Council for Mental Wellbeing has developed a new toolkit to empower behavioral health providers to claim their role as an authority on generally accepted standards of care. This new toolkit was developed with input from a number of mental health and substance use disorder organizations.

Our toolkit provides a compelling argument for upholding generally accepted standards of care and practical tools for implementing an effective appeal strategy, including appeal letter templates, insurance claim review talking points, and an educational infographic. The recommended approach supplements general appeal guidance with important findings from the landmark federal court ruling of the Wit vs UBH case. This groundbreaking ruling established a clear set of generally accepted standards of care that is consistent with widely accepted professional sources of standards.