The Minnesota Department of Commerce today announced a settlement in the form of a Consent Order with UnitedHealthcare that stemmed from the Department’s examination of UnitedHealthcare Insurance Company.  The settlement requires UnitedHealthcare to revamp its policies and procedures to ensure parity in its coverage of mental health care.  These changes aim to help remove obstacles and expand access to mental health and substance use disorder care for Minnesotans.  

The Consent Order alleges UnitedHealthcare violated Minnesota’s mental health parity laws by evaluating mental health and substance abuse claims more stringently than claims for other types of medical care.  

As part of the Consent Order, Commerce imposed a $450,000 fine.  A portion of this fine must be paid now, but a portion of it will only be imposed if UnitedHealthcare does not complete the items listed in its corrective action plan.  Commerce will continue to monitor UnitedHealthcare for compliance with the Consent Order and the corrective action plan.  

“Consumers have the right to access mental health care covered by insurance on par with coverage for other medical care,” Commerce Commissioner Grace Arnold said. “Commerce is committed to protecting consumers, ensuring Minnesotans can access mental health care when they need it, and that every insurance company follows the law.”   

State and federal parity laws prohibit health insurers from making it more difficult to obtain care for mental and substance use disorders than for medical and surgical services.  The specific allegations against UnitedHealthcare include that the company:  

• Did not demonstrate comparability in reimbursement rates between medical/surgical and mental health and substance abuse disorder providers for certain billing codes;  
• Did not maintain accurate and complete provider directories;  
• Engaged in utilization review practices and procedures that did not document the number of requested and denied days or units or properly document utilization review-related data;  
• Did not advise insureds and enrollees in certain situations of their appeal rights for denied days or units; 
• Posted prior authorization data on its public website that was untimely or inaccurate; and 
• Applied some formulary design restrictions more stringently for mental health prescription drugs.  

This is the third, and largest, civil penalty Commerce has assessed against an insurance carrier in the past 12 months related to mental health parity.   

“This examination allowed Commerce to assess UnitedHealthcare’s systemic operations and policies for covering mental health and substance use care.  I am happy the company has agreed to take steps to address Commerce’s allegations and hope these changes will improve mental health care coverage for its members,” said Commerce Assistant Commissioner of Enforcement Jacqueline Olson.  

More information: Commerce’s Consent Order with UnitedHealthcare 

Minnesota Consumer Service Center   

Consumers who have complaints or concerns about health insurance, including mental health coverage, can contact Commerce’s Consumer Service Center.  

• File a complaint online  
• Email or call: consumer.protection@state.mn.us | 651-539-1600.   
• Verify whether an insurance agent or insurance company is licensed to do business in Minnesota with our License Lookup. 
• Search Commerce Actions and Regulatory Documents to view past enforcement actions. 

Connect with the Minnesota Commerce Department  

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

MEDIA CONTACT:

Mo Schriner, Communications Director  
Minnesota Department of Commerce  
mo.schriner@state.mn.us