The state’s insurance commissioner said Nov. 4 that UnitedHealthcare faces a $1 million fine for inaccurately calculating members’ out-of-pocket costs for autism claims, delaying payment and improperly handling claims for mental healthcare, and not promptly responding to consumer complaints.
UnitedHealthcare cooperated with the department’s investigation and agreed to create an $800,000 public outreach campaign to help members better understand mental health and substance use disorder benefits. The insurer also agreed to reimburse wrongly denied claims, overpaid out-of-pocket expenses and interest on delayed claims.
The Pennsylvania Insurance Department said it will verify whether the corrective actions have been taken in a future reexamination.
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