UnitedHealth Agrees To Settle Federal & New York Charges Over Mental Health/Substance Abuse Coverage

By John F. Heerdink, Jr.

Reportedly, UnitedHealth Group Incorporated (UNH) has agreed to settle federal and New York state charges that it illegally denied coverage to thousands of patients suffering from mental health problems and substance abuse. The U.S. Department of Labor said that UnitedHealth will pay about $15.7 million, including $13.6 million in restitution and a $2.1 million fine, to reach a settlement with that agency and New York Attorney General Letitia James.

UnitedHealth was charged with violating federal and state laws by imposing more stringent and restrictive limits on treatment and coverage for mental health and substance abuse in comparison to physical health conditions. The largest U.S. health insurer agreed to stop using algorithms, including in a program called ALERT, that required multiple layers of assessment before continuing mental health treatment, usually resulting in coverage being cut off.

UnitedHealth agreed to settle and ensured to no longer use the challenged practices, including ALERT. It also committed to providing care, including “behavioral support,” and reimbursement to policyholders as per the federal and state rules.

Dow 30 component UnitedHealth Group Incorporated (UNH) operates as a diversified health and well-being company in the United States. The company’s UnitedHealthcare segment offers consumer-oriented health benefit plans and services for national employers, public sector employers, mid-sized employers, small businesses, individuals, and military service members; and health care coverage, and health and well-being services to individuals aged 50 and older addressing their needs for preventive and acute health care services. To learn more about (UNH) please visit the Vista Partners Company Dedicated UNH Coverage Page.

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