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• Additional Info:

  The provisions of the Health Insurance Portability and Accountability Act (HIPAA) prevent UnitedHealth Group from providing detailed information about consumer health issues without a HIPAA - compliant authorization from the consumer that fulfills HIPAA privacy requirements and allows UnitedHealth Group to share private health information with the BBB. If consumers do not include an authorization that complies with HIPAA, UnitedHealth Group will contact the consumer directly and notify the BBB the contact was made.

   

  Optum 2001 Integrity Awards Winner

• Government Actions:

  Government Action: BBB reports on known government actions involving business’ marketplace conduct:

  Minnesota Dept. of Commerce Consent Order
  

  On May, 2, 2024, the business entered into a Consent Order with the Minnesota Department of Commerce. The Consent Order settles allegations that the business did "not demonstrate comparability in reimbursement rates between medical/surgical (M/S) providers and mental health and substance abuse disorder (MH/SUD) providers for certain identified Current Procedural Terminology (CPT) billing codes, in violation of Minn. Stat. § 62Q.47(d) and (e) (2022)." And "Did not maintain accurate and complete provider directories, in violation of Minn. Stat. §§ 62K.075 and 72A.20, subd. 2(2022)." And "Engaged in utilization review practices and procedures that violated Minn. Stat. §§ 62M.05, 62M.09, and 62Q.47(d) and (e) (2022) by not: Documenting the number of requested and denied days or units, Properly documenting utilization review-related data, and Advising insureds and enrollees of their appeal rights for denied days or units." In addition, the allegation states the business "Did not timely post and posted inaccurate MH/SUD prior authorization statistics on its public website, in violation on Minn. Stat. §§ 62M.18 and 72A.20, subd. 2 (2022)." And "Applied formulary design restrictions more stringently for certain MH/SUD prescription drugs than for M/S prescription drugs, in violation of Minn. Stat. § 62Q.47(d) and (e) (2022) and Submitted comparative analyses lacking sufficient information for the Department (of Commerce) to determine whether the analyses met the requirements of Minn. Stat. §62Q.47(d), (e), and (f) (2022). See also 42 U.S.C. § 300gg-26(a)(8)(A)" and "Did not provide adequate explanations of benefits to insureds and enrollees, in violation of Minn. Stat §§ 72A.20, subd. 12(14) and 72A.201, subd. 5(6) (2022)".

  Under terms of the Consent Order, the business agreed to comply with the corrective action plan as monitored by the Minnesota Department of Commerce; comply with the licensure and staff criteria of Minn. Stat. 62M.09 (2022) and to pay $300,000.00 of a $450,000.00 penalty, with the balance stayed on the condition that the action plan is completed. The Consent Order was for settlement purposes only and should not be considered as an admission of guilt or finding of violation of the law. For more details go to the below link.

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