UnitedHealthcare faces state penalty for uneven mental health care coverage

Published 4:07 pm Tuesday, May 14, 2024

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By Estelle Timar-Wilcox, Minnesota Public Radio News

UnitedHealthcare is facing penalties for allegedly violating mental health parity laws.

After an investigation, the Minnesota Department of Commerce said the company covers claims for mental health and substance abuse care more stringently than it covers claims for other services.

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The department announced a settlement in the form of a consent order with the insurance company on Tuesday.

State officials outlined several issues with UnitedHealthcare’s mental health care coverage. Those include uneven reimbursement rates between mental health and other care, and a failure to inform some patients of their appeal rights when coverage was denied.

The commerce department will monitor UnitedHealthcare’s progress on changes mandated by the consent order until March 2025, or until all the changes have been made — whichever comes later.

The department said in its announcement that those changes will make it easier for customers to access care for mental health and substance abuse.

“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.

UnitedHealthcare is also facing a $450,000 fine. The company has to pay $300,000 now; the rest will be waived if it makes the changes outlined in the consent order.

A UnitedHealthcare spokesperson said the company is committed to covering mental health care.

“We will continue working with state officials to address the issues they identified and remain dedicated to collaborating with people in Minnesota to deliver high quality, affordable health care,” a spokesperson said.

This is the third — and largest — state penalty on an insurance carrier for mental health parity in the last year. The Department of Commerce has also penalized HealthPartners and Medica for alleged violations.