(Reuters) – UnitedHealth Group Inc., the largest US health insurance company, has settled federal and New York state fees as it illegally denied coverage to thousands of patients suffering from mental health problems and substance abuse.
The US Department of Labor said on Thursday that UnitedHealth will pay approximately $ 15.7 million, including $ 13.6 million in repayments and $ 2.1 million, to settle with that agency and New York Attorney General Letitia James .
Authorities accused UnitedHealth of violating federal and state laws by imposing more restrictive limits on coverage and treatment for mental illness and substance abuse than it prescribed for physical health conditions.
UnitedHealth was also accused of overburdening patients for off-network psychiatric services by reducing reimbursement.
Without acknowledging responsibility, UnitedHealth agreed to stop using algorithms, including in a program called ALERT, which required additional layers of rev iew before continuing mental health care and often resulted in discontinuation of coverage.
UnitedHealth, based in Minnetonka, Minnesota, said in a statement that it was nice to resolve and no longer use the challenged methods, including ALERT.
It also stated that it was committed to providing care, including "behavioral support" and compensation to policyholders in accordance with federal and state regulations.
Ms. James said more than 20,000 New Yorkers will receive $ 9 million from the settlement, and the state will receive $ 1