UnitedHealthcare Settles with Minnesota Over Alleged Violations of State Parity Law

On May 2, 2024, UnitedHealthcare Insurance Company settled with the Minnesota Department of Commerce over allegations that the carrier violated the state’s mental health parity law.

Although the carrier neither admitted nor denied the allegations, the department alleged that it:

• Did not demonstrate comparability in reimbursement rates between medical/surgical and mental health and substance abuse disorder providers for certain billing codes.
• Did not maintain accurate and complete provider directories.
• Engaged in utilization review practices and procedures that did not document the number of requested and denied days or units or properly document utilization review-related data.
• Did not advise insureds and enrollees in certain situations of their appeal rights for denied days or units.
• Posted prior authorization data on its public website that was untimely or inaccurate.
• Applied some formulary design restrictions more stringently for mental health prescription drugs.

The carrier agreed to follow a corrective action plan (CAP) and pay a penalty of $300,000. The CAP requires the carrier to establish policies, procedures, and remedies that address the issues identified in the consent order. If the carrier fails to follow the CAP, it must pay an additional penalty of $150,000.

Employers with group health plans issued in the state should be aware that the state is rigorously enforcing its mental health parity laws.

Consent Order »