After an investigation and litigation by the Department of Labor and New York State Attorney General it was determined that United Behavioral Health and United Healthcare is to pay $13.6 million to affected participants, $2,084,249 in penalties, and take other corrective action. Going back until at least 2013, the investigation found that United was reducing reimbursement rates for out of network mental health services. This led to participants being overcharged for services, as well as, flagged for utilization reviews due to the participant seeking mental health treatment. This flag caused many denials of payment to those participants for the services. The investigation was led by the Employee Benefits Security Administration.
This action by United violated the Mental Health Parity and Addiction Equity Act of 2008. This act prohibits health plans, covered by the Employee Retirement Income Security Act, from imposing limitations to mental health or substance use disorder benefits. Due to the denial of payments many participants or beneficiaries did not receive the treatment they were entitled to under the Act. It was found that United was failing to disclose pertinent information on these plans and practices to the participants and because of this settlement they now agree to improve their disclosure processes and make treatment accessible to their plan participants.
With the pandemic causing many mental health concerns the Department of Labor is making it a priority for individuals to be able to seek and receive mental health treatment. Adding special hurdles or obstacles in the path of individuals seeking mental health versus physical health is not allowed under the Act. The New York Attorney General quoted that United’s denial of the mental health services was both “unlawful and dangerous” given the current climate due to the pandemic. With Mental Health becoming more and more important to overall well-being, employers should be aware that it is not only good business to provide services to their employees and dependents by also know that the Department of Labor is taking steps to enforce the acts that cover these services.