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Pennsylvania Insurance Department fines UnitedHealthcare $1 million

Intelligencer Journal - 11/6/2019

Pennsylvania Insurance Department has fined UnitedHealthcare $1 million, it announced this week.

The department said an examination that covered January 2015 through March 2016 "found extensive noncompliance with mental health parity and prompt pay laws, as well as concerns with the company's coverage for services relating to autism spectrum disorders and substance use disorders."

The department said the insurer also agreed to develop an $800,000 public outreach campaign to educate consumers about their mental health and substance use disorder benefits and agreed to pay restitution to consumers from claims wrongly denied, overpaid out-of-pocket expenses, and interest on delayed claims.

"While we have already made changes, we will continue to make improvements to help individuals get care under their plans," the insurer said in a prepared statement.

Parity laws require coverage for substance use disorders and mental health to be offered at the same level of benefits as medical or surgical treatment.

The department is conducting similar examinations emphasizing mental health and substance use disorder parity on all of Pennsylvania's major health insurers and finished two: Aetna, which was fined $190,000, and Blue Cross of Northeastern Pennsylvania, which was fined $90,000.

The department said it will make sure corrective actions have been taken "through a reexamination process" and noted that the company has been "cooperative."

Crédito: HEATHER STAUFFER | Staff Writer


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