UnitedHealthcare to Pay $15.6 Million in Settlement Over Mental Health Coverage

United Behavioral Health and United Healthcare Insurance will pay a total of $15.6 million in a settlement after an investigation and litigation by the U.S. Department of Labor and the state attorney general in New York.

The New York regional office of DOL’s Employee Benefits Security Administration found that United had overcharged its plan participants for out-of-network mental health services by reducing reimbursement rates, and the insurer also flagged participants undergoing mental health treatments for utilization review—a practice that led to payment denial for many services. The practices were found to have been used since at least 2013.

According to DOL, United’s actions violated the Mental Health Parity and Addiction Equity Act, which protects health plans covered by the Employee Retirement Income Security Act (ERISA) from treatment limitations for mental health and SUD benefits that are more restrictive than what is imposed on medical and surgical benefits.

United Behavioral Health and United Healthcare Insurance will pay $13.6 million to affected participants and beneficiaries, as well as $2.08 million in penalties. United will also take additional corrective actions, per terms of the settlement.

“Plans and insurance companies cannot place special hurdles in the paths of workers and their families when they seek mental health and substance use disorder benefits,” Acting Assistant Secretary for Employee Benefits Security Ali Khawar said in a news release. “The law requires parity between these benefits and medical benefits. We are committed to vigorously enforcing the law’s requirement and making sure workers in need of help are treated fairly.