UnitedHealthcare fined for substance use disorder coverage | Rhode Island News

PROVIDENCE, RI (AP) — Rhode Island regulators have ordered UnitedHealthcare to pay $100,000 to resolve allegations that the insurer failed to follow state law when determining treatment coverage substance use disorders.

The Office of the Rhode Island Health Insurance Commissioner periodically reviews insurance companies to determine their compliance with state insurance laws. The office signed a consent agreement with UnitedHealthcare after a review of the insurer’s practices.

UnitedHealthcare said in a statement Thursday that it is working with the state to address concerns and continue to improve its processes. A spokesperson said they look forward to working with the state to ensure residents have access to the appropriate care they need.

He must submit a corrective action plan to the State within 90 days.

UnitedHealthcare has not accepted the allegations or any violation of law in the consent agreement. The agreement states that UnitedHealthcare wanted to avoid the long and costly process of other procedures.

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The health commissioner’s office said it found that UnitedHealthcare failed to follow guidelines put in place by the American Society of Addiction Medicine when determining coverage for treatment of substance use disorders. 2015 to 2018, as required by state law. The bureau reviewed 67 cases where a request for coverage was denied, according to the agreement.

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