Minnesota health insurance regulators have fined Minnetonka-based UnitedHealthcare $450,000 for allegedly failing to comply with the Mental Health Parity Act.
The settlement announced Tuesday is the third and largest in a series of consent orders between the state Department of Commerce and health insurance companies over the Equality Act since May 2023. The law prohibits health insurance companies from making it more difficult for patients to obtain mental health and substance use disorder services than medical/surgical treatment.
According to a consent order dated May 2, UnitedHealthcare neither admitted nor denied the charges.
“Consumers have the right to have mental health care covered along with their other medical care coverage,” Commerce Commissioner Grace Arnold said in a statement. “The Department of Commerce is committed to protecting consumers, ensuring Minnesotans have access to mental health care when they need it, and ensuring all insurance companies comply with the law.”
The nation’s largest health insurance company announced last summer that it would add providers and adjust benefits across the country in response to a significant increase in patients seeking care for mental health and substance use disorders.
UnitedHealthcare said it will continue to work with state officials to address issues identified by regulators. The company says it has made significant progress in expanding its behavioral health network in Minnesota in recent years, including adding approximately 13,000 behavioral health providers statewide since 2019.
“We are committed to ensuring our members have access to behavioral health services that meet their needs and help them live healthier lives, while meeting the requirements of Minnesota law,” UnitedHealthcare said in a statement. ” he said.
A portion of the fine ($300,000) must be paid now, while the remainder will only be imposed if UnitedHealthcare does not complete its corrective action plan.
The state says the company must review its policies and procedures to ensure equal coverage of mental health care. The goal is to remove barriers and expand access to care for mental health and substance use disorders, the Commerce Department said in a news release.
Regulators will monitor UnitedHealthcare until March 31 of next year, and beyond if a corrective action plan is not yet completed.
The state found that UnitedHealthcare violated six different provisions of the Equality Act, including failing to certify comparable payment rates for mental health and physical health care providers and stricter rules for patients requiring psychiatric medications. he claimed.
Regulators say UnitedHealthcare did not maintain an accurate and complete roster of providers and used screening practices and procedures that did not document the number of days of care requested and days of denied care.
Commerce also claims that the company failed to inform some patients of their right to appeal treatment denials and posted untimely or inaccurate data on prior authorizations on its public website. did.
UnitedHealthcare is the health insurance division of UnitedHealth Group. The consent order also includes PreferredOne, which the company acquired in 2021.
Health Partners and Medica also agreed in May and July 2023 to pay fines and make changes without admitting or denying the charges. The Commerce Department’s actions over the past year come as federal regulators have stepped up their enforcement efforts by increasing reporting from health insurance companies.
