UnitedHealthcare is facing a fine of up to $450,000 for allegedly violating Minnesota’s mental health parity laws.

The Minnesota Department of Commerce on Tuesday announced that it reached a settlement in the form of a consent order with the Minnetonka-based insurance giant. Commerce department officials said the agreement will require UnitedHealthcare to “revamp its policies and procedures to ensure parity in its coverage of mental health care.”

Under Minnesota law, insurers cannot make it more difficult to access mental health care or substance use disorder treatment than other kinds of health care. The state is authorized to compare how insurers provide access to mental health care treatments and other medical conditions; that could include comparing prior authorization requirements, claim denials, rehabilitation services, and more.

Commerce department officials allege that UnitedHealthcare “did not demonstrate comparability in reimbursement rates between medical/surgical and mental health and substance abuse disorder providers for certain billing codes,” according to the consent order. The department went on to allege that UnitedHealthcare didn’t maintain “accurate and complete provider directories,” and failed to advise patients in certain situations of their “appeal rights for denied days or units.”

The consent order states that UnitedHealthcare neither admits nor denies the allegations. The order also applies to PreferredOne Insurance Co., another health insurer that UnitedHealth Group acquired back at the end of 2021.

The commerce department examined mental health access at UnitedHealthcare and PreferredOne in early 2022.

“Consumers have the right to access mental health care covered by insurance on par with coverage for other medical care,” said Grace Arnold, commissioner of the department of commerce, in a news release. “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.”  

UnitedHealthcare, which is the health insurance arm of Minnetonka-based UnitedHealth Group, must pay an initial $300,000 civil penalty within 30 days of the consent order. It won’t have to pay the remaining $150,000 if it follows the state’s corrective action plan, according to the order.

UnitedHealthcare isn’t the only Minnesota insurer to face fines for alleged infractions related to mental health parity; a year ago, the commerce department levied fines against both Medica and HealthPartners. But UnitedHealthcare’s fine is the largest within the last 12 months, commerce department officials noted.

In an email to TCB, UnitedHealthcare said that it will “continue working with state officials to address the issues they identified and remain dedicated to collaborating with people in Minnesota to deliver high quality, affordable health care.”

“UnitedHealthcare has made significant progress in the past few years to expand our behavioral health network, including growth in Minnesota of 60% since 2019 to almost 13,000 behavioral health providers statewide, and over 390,000 nationwide,” the company said.