New York secured $1 million from UnitedHealthcare over unlawful contraceptive-coverage restrictions
Company: UnitedHealth Group
Summary
On June 20, 2024, the New York Attorney General announced a settlement requiring UnitedHealthcare of New York, part of UnitedHealth Group's UnitedHealthcare insurance business, to pay a $1 million penalty and reimburse affected consumers after an investigation into contraceptive coverage. UnitedHealth Group identifies UnitedHealthcare as one of its two principal operating businesses. The Attorney General's Health Care Bureau opened its investigation after a Brooklyn patient complained that a UnitedHealthcare Oxford plan denied coverage for an oral contraceptive. The patient's appeal was rejected, and the plan required prior authorization or step therapy—requiring the patient to try alternatives first. The Attorney General stated that the resulting denial and delay forced the patient to go without the prescribed birth control and violated New York's Comprehensive Contraceptive Coverage Act. That law requires health plans to cover FDA-approved contraceptives without copays, restrictions or delays. Under the settlement, UnitedHealthcare agreed to pay the $1 million penalty, ensure that its New York plans provide legally required contraceptive coverage, and train staff involved in contraceptive claim approvals. It also agreed to reimburse consumers for out-of-pocket contraceptive costs, plus 12 percent interest. The reimbursement provisions cover eligible payments dating from June 1, 2020 onward. Primary source — Office of the New York Attorney General: https://ag.ny.gov/press-release/2024/attorney-general-james-announces-settlement-unitedhealthcare-failing-provide Corporate relationship — UnitedHealth Group: https://www.unitedhealthgroup.com/uhg/businesses.html This record concerns the conduct and settlement obligations of the New York UnitedHealthcare insurance entity. It is attributed to UnitedHealth Group through the UnitedHealthcare operating business; it should not be generalized to every UnitedHealth plan or subsidiary.
Record details
- Category
- Corporate Misconduct
- When it happened
- June 1, 2020–June 20, 2024
- Status
- Resolved (June 20, 2024)
- Severity
- medium
- Added to Rotten Company
Source
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