Minnesota health insurance regulators are imposing a $450,000 fine against UnitedHealthcare over allegations the Minnetonka-based company failed to comply with mental health parity laws.
Minnesota fines UnitedHealthcare $450K over alleged mental health parity violations
The settlement is third in a series where insurers did not admit or deny allegations. HealthPartners and Medica previously agreed to pay fines.
The Minnesota Star Tribune
May 14, 2024 at 3:23PM
The settlement announced Tuesday is the third and largest in a series of consent orders since May 2023 between the state Department of Commerce and health insurers over parity statutes. The laws prohibit health insurers from making it more difficult for patients to get mental health and substance use disorder services than medical/surgical treatments.
UnitedHealthcare neither admitted nor denied the allegations, according to a consent order dated May 2.
“Consumers have the right to access mental health care covered by insurance on par with coverage for other medical care,” Commerce Commissioner Grace Arnold said in a statement. “Commerce is committed to protecting consumers, ensuring Minnesotans can access mental health care when they need it, and that every insurance company follows the law.”
The company, which is the nation’s largest health insurer, announced last summer it was adding providers and adjusting benefits across the country in response to a significant increase in patients seeking care for mental health and substance use disorders.
UnitedHealthcare said it would continue working with state officials to address the issues identified by regulators. The company says it’s made significant progress in recent years to expand its behavioral health network, including growth in Minnesota since 2019 to almost 13,000 behavioral health providers statewide.
“We are committed to ensuring our members have access to the behavioral health services that meet their needs and help encourage them to lead healthier lives, while meeting requirements under Minnesota state law,” UnitedHealthcare said in a statement.
A portion of the fine — $300,000 — must be paid now, but the remainder will be imposed only if UnitedHealthcare does not complete a corrective action plan.
The company is required to revamp policies and procedures to ensure parity in coverage for mental health care, the state says. The goal is to remove obstacles and expand access to mental health and substance use disorder care, the commerce department said in a news release.
Regulators will monitor UnitedHealthcare until March 31 next year or beyond if the corrective action plan has not yet been completed.
The state alleged UnitedHealthcare violated six different parity law provisions, including a failure to demonstrate comparable payment rates for mental and physical health care providers as well tougher rules for patients requiring mental health medications.
UnitedHealthcare did not maintain accurate and complete provider directories, regulators said, and used review practices and procedures that did not document the number of requested and denied days of care.
Commerce also alleged the company did not advise some patients of their appeal rights for denied care, and posted untimely or inaccurate data on prior authorizations on the company’s public website.
UnitedHealthcare is the health insurance division of UnitedHealth Group. The consent order also covers PreferredOne, which the company acquired in 2021.
In May and July 2023, HealthPartners and Medica also agreed to pay fines and make changes without admitting or denying allegations. Commerce’s actions over the past year have come as federal regulators have stepped up enforcement efforts through more reporting from health insurers.
Pioneering surgeon has run afoul of Fairview Health Services, though, which suspended his hospital privileges amid an investigation of his patient care.
