Pennsylvania officials on Monday announced a fine of $ 1 million against the United Health Insurance giant for refusing or sometimes not paying customer claims for mental health care.
The United States also calculated total inaccurate consumer costs for autism claims, according to the government insurance department. Officials said the company’s actions violated the Federal Equality in Mental Health and Addiction Equity Act of 2008.
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The Insurance Department said the Mental Health Parity Act requires health insurance plans with equivalent levels of coverage for mental health care and substance use disorders, as is the case for medical or surgical care. This law covers quantitative restrictions, such as copays, discounts, restrictions on inpatient or outpatient visits covered, as well as other restrictions on access to care, such as prior licenses, the number of providers available through the plan network, and what plan is considered “Medically necessary”.
United said it was working closely with state officials to address their concerns.
“Although we have already made changes, we will continue to make improvements to help individuals get care under their plans,” the company said in a statement. “We will work with the insurance department to help more Pennsylvania residents meet their mental health needs by providing additional resources and education to help them understand and access their benefits.”
In addition to paying the fine, United agreed to spend $ 800,000 on a public awareness campaign to educate Pennsylvania consumers about the benefits of mental health and substance use disorders, and to pay an unspecified amount of compensation to consumers whose claims were wrongly rejected – pocket money, which incurred interest. On overdue claims.