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NY AG says UnitedHealthcare must pay $1M for not providing birth control coverage
By
Catalina Gonella
Published Jun 20, 2024
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Lev Radin/Pacific Press/LightRocket via Getty Images
By
Catalina Gonella
Published Jun 20, 2024
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UnitedHealthcare, the country’s largest health insurer, will pay a $1 million penalty for failing to provide birth control coverage, a violation of New York state law, Attorney General Letitia James announced on Thursday.
When a patient in Brooklyn submitted a complaint to the attorney general's office after UnitedHealthcare’s Oxford plan denied them coverage for their oral contraceptive, the attorney general’s office opened an investigation into the company, according to a press release. James' office said the patient’s appeal had been rejected and their health plan required them to get prior authorization or alternative treatments, forcing them to go without their birth control.
That violated New York's Comprehensive Contraceptive Coverage Act, or CCCA, which requires health insurance plans to cover contraceptives approved by the U.S. Food and Drug Administration without copays, restrictions or delays, according to the attorney general.
“Birth control is an important medication that millions of people use every day,” said James. “Denying health insurance coverage of birth control can cause serious health concerns for anyone who takes the medication. Reproductive health care is essential to the safety and well-being of New Yorkers, and it is crucial that health insurers abide by New York’s reproductive health care laws.”
James also announced that on top of the $1 million penalty, UnitedHealthcare will also reimburse consumers who paid out of pocket for birth control, plus 12% interest. Eligible customers will receive their payment by mail and those with potential claims will be notified and asked to submit a claim, the attorney general’s office said.
The company also must ensure all of its health plans comply with the CCCA and must train all staff involved in the claims approvals process for contraception on compliance with New York laws, according to James.
She encouraged New Yorkers who may have wrongfully been denied coverage by their health insurance company to contact her office and file a complaint. Consumers covered by UnitedHealthcare who paid for birth control and believe they should have been covered can submit a claim by emailing [email protected].
UnitedHealthcare did not immediately respond to a request for comment on Thursday.
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