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Consent order requires HealthPartners to revamp processes for mental health coverage to comply with parity laws

5/4/2023 12:12:12 PM

The Minnesota Department of Commerce today announced the results of a review of HealthPartners’ business practices that will result in the company revamping its processes and policies to ensure coverage for mental health care is equivalent to coverage for medical or surgical care. HealthPartners’ systemic changes will remove obstacles and expand access to mental health care for Minnesotans. 

A consent order resulting from the market conduct exam alleges that HealthPartners violated what are known as mental health parity laws by evaluating mental health and substance abuse claims more stringently than claims for other types of care. The order also alleges that HealthPartners did not adequately analyze or justify reimbursement rates for mental health or substance abuse treatments that were lower than comparable medical procedures. Commerce also imposed a $150,000 fine and will monitor HealthPartners’ adherence to its new procedures for at least a year. 

“Access to mental health care has never been more important,” Commerce Commissioner Grace Arnold said. “We are committed to ensuring Minnesotans get mental health and substance abuse care when they need it. That means holding insurers accountable and targeting obstacles that may make mental health care more difficult to access than other medical care. We’ll continue to make sure all insurers abide by Minnesota law.” 

State and federal parity laws prohibit health insurers from making it more difficult to get mental and behavioral health care than treatment for other health conditions. 

The consent order alleges that HealthPartners violated parity laws by excluding some coverage for residential mental health treatment before 2018. It also alleges that HealthPartners reconsidered its denials of claims for medical or surgical procedures more often than its denials of claims for mental health care. Further, the order alleges that HealthPartners did not document its internal coverage reviews or meet required timelines. 

“The Department of Commerce regularly examines the practices of health insurance companies, including compliance with parity laws, and we take seriously any allegations of violations,” said Jacqueline Olson, Commerce Assistant Commissioner for Enforcement. “Today’s consent order benefits Minnesotans because it compels a large insurer to make major changes. Those changes will expand access to mental health care in our state. We will not permit insurers to jeopardize access to treatment for Minnesotans who need it.” 

In setting the $150,000 fine, Commerce considered HealthPartners’ cooperation during the exam, its commitment to certain claims repayments, and its dedication of resources to implement its corrective action plan. 

Get updates and news from the Minnesota Department of Commerce by following Commerce at mn.gov/commerce or @MNCommerce on social media. 


MEDIA CONTACTS: 

Brett Benson
Assistant Director of Communication
Minnesota Department of Commerce
brett.benson@state.mn.us

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