Health plan UnitedHealthcare has agreed to pay a $250,000 fine to settle with the state's Department of Insurance over letters it sent to policyholders concerning a health system in its network. The health plan sent out letters in May informing some members that they would have to change providers, given that a central Ohio health system, OhioHealth, appeared to be on the verge of giving up its contract. The letters said that beneficiaries would need to find new providers as of June 10--making no mention of the fact that UnitedHealthcare was still in contract talks with the health system.
Ultimately, OhioHealth and UnitedHealthcare managed to seal a deal seven hours before their contract was set to expire. That meant that despite the letters, UnitedHealthcare's beneficiaries could continue to see their OhioHealth providers. Because of the letter, however, patients made scores of calls to physician practices and OhioHealth's three hospitals, seeking reassurance that they could still see their existing providers.
The Department of Insurance, which dubbed the letters "confusing" and "misleading," is requiring UnitedHealthcare to submit a plan describing how it will improve its communications with members. The fines it imposed include a $150,000 civil penalty and $100,000 in administrative costs.
To find out more about the investigation:
- read this Marion Star piece
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