A 37-jurisdiction settlement agreement may free a large managed care company from the traditional state-by-state market examination process.
The UnitedHealthcare insurance and managed care units of UnitedHealth Group Inc., Minnetonka, Minn., have agreed to pay $12 million up front to resolve regulators’ concerns about claims practices involving matters such as coordination of benefits, appeals and grievances, explanations of benefits, and utilization review.
UnitedHealth’s health coverage units also has agreed to meet new performance standards over the next 3 years, and it has agreed to pay up to $20 million in additional penalties if it fails to meet the new standards, the company says.
Regulators in many states were looking into complaints about the UnitedHealth units’ claims-paying practices a few years back.
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In December 2006, Iowa Insurance Commissioner Susan Voss worked through the National Association of Insurance Commissioners, Kansas City, Mo., to negotiate a multistate settlement agreement draft.
The proposal called for the agreement to take effect if at least 30 states signed the agreement by Aug. 27, 2007.