UnitedHealthcare fined $450,000 for illegal barriers to mental health coverage
UnitedHealth CEO Andrew Witty testified before the U.S. Senate Finance Committee on Wednesday, May 1, 2024, about a cyberattack on Change Healthcare, a subsidiary. Screenshot from committee webcast.
The Minnesota Department of Commerce has issued a $450,000 fine and entered a consent order with Eden Prairie-based UnitedHealthcare after finding the company illegally made it harder for customers to get reimbursed for mental health care.
According to the consent order, UnitedHealthcare made mental health reimbursements harder to obtain than regular medical or surgical reimbursements, which is a violation of state law. It placed more restrictions on some medications used to treat mental health disorders. The company also failed to maintain accurate provider directories, and didn’t properly document denials or advise customers of their right to appeal.
“Consumers have the right to access mental health care covered by insurance on par with coverage for other medical care,” said Commerce Commissioner Grace Arnold in a press release.
The company also posted inaccurate statistics about its prior authorization practices, which require doctors to get permission from insurers for some medically necessary treatments before administering them.
The company neither admitted nor denied wrongdoing, but it waived its right to a hearing to address the allegations and agreed to the fine and consent order.
Under the order, UnitedHealthcare must comply with a corrective action plan to address coverage shortcomings and be monitored by the Department of Commerce until March 2025. If all the deficiencies are addressed by then, part of the fine will be waived.
“I am happy the company has agreed to take steps to address Commerce’s allegations and hope these changes will improve mental health care coverage for its members,” said Commerce Assistant Commissioner of Enforcement Jacqueline Olson.
UnitedHealth, the parent company of UnitedHealthcare, has been under intense scrutiny following a massive data breach at a subsidiary that handles $2 trillion in insurance claims each year. The breach has been especially disruptive to small medical providers, who often have no alternative way to process payments.
The firm has been on a buying binge of many of those same small companies and is now reportedly the subject of a Department of Justice antitrust investigation.
Meanwhile, ProPublica reported last year that the company has been relentless in its efforts to reduce spending on some of its sickest customers, even as its profits rose to $22 billion in 2023.
Those profits were dependent, in part, on the company’s ruthless focus on cost-cutting, including the illegal restrictions on mental health reimbursement documented in the Commerce Department’s consent decree.
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