UnitedHealthcare to pay $15.6M in mental health parity settlement

Gavel on top of cash
The settlement resolves violations of the Mental Health Parity and Addiction Equity Act, which prevents employer plans from limiting mental health benefits. (alfexe / iStock / Getty Images Plus)

UnitedHealthcare will pay $15.6 million to settle federal and state investigations into mental health parity, the Department of Labor announced Thursday.

The settlement includes $13.6 million in payments to members for wrongfully denied claims as well as just over $2 million in penalties and lawyers fees, DOL said.

An investigation by DOL's Employee Benefits Security Administration found that UnitedHealth would reduce reimbursement rates for out-of-network behavioral health services and would flag members who were undergoing mental health treatment for utilization reviews.

UnitedHealthcare also failed to sufficiently disclose information about its practices to plan sponsors and members, according to DOL.

RELATED: Why judge’s ruling against UnitedHealth could be turning point for mental health parity

The actions violated the Mental Health Parity and Addiction Equity Act (MHPAEA), which blocks Employee Retirement Income Security Act (ERISA) plans from limiting benefits for mental health and substance abuse treatment.

Acting Assistant Secretary for Employee Benefits Security Ali Khawar said on a call with reporters that mental health parity enforcement is a key health priority at DOL under the Biden administration.

"It does signify another step in our efforts to meet the promise of MHPAEA," Khawar said.

UnitedHealth Group, the parent company of UnitedHealthcare, said in a statement to Fierce Healthcare that the company is "pleased to resolve these issues related to business practices no longer used by the company."

"We are committed to ensuring all our members have access to care and to reimbursing providers consistent with the terms of the member’s health plan and state and federal rule," UnitedHealth Group said. "As part of our broader commitment to quality care, we continue to support our members with increased access to providers and new ways to get the effective behavioral support they need."

UnitedHealth is the country's largest private insurer. In addition to the financial settlement, the insurer said it would cease the behaviors uncovered in the investigation, improve outreach to plan sponsors and commit to compliance in the future.