PROVIDENCE, R.I. (AP) — Rhode Island regulators ordered UnitedHealthcare to pay $100,000 to resolve allegations that the insurer didn’t follow state law when determining coverage for substance use disorder treatment.
Rhode Island’s Office of the Health Insurance Commissioner periodically examines insurance companies to determine 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 worked with the state to address the concerns and continue to enhance its processes. A spokesperson said they look forward to collaborating with the state to ensure residents have access to the appropriate care they need.
It must submit a corrective action plan to the state within 90 days.
UnitedHealthcare did not agree to the allegations or to any violations of law in the consent agreement. The agreement states that UnitedHealthcare wanted to avoid the expense and time-consuming process of further proceedings.
The health commissioner’s office said it found UnitedHealthcare did not follow guidelines put in place by the American Society of Addiction Medicine when determining coverage for substance use disorder treatment from 2015 to 2018, as required by state law. The office reviewed 67 instances where a request for coverage was denied, according to the agreement.
