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Life Health > Health Insurance

Ohio Issues Plan Communications Fine

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The Ohio Department of Insurance has imposed a $150,000 fine and $100,000 in administrative costs on a health carrier in response to concerns about provider negotiations notices.

The department imposed the costs on United HealthCare of Ohio Inc., a unit of UnitedHealth Group Inc., Minnetonka, Minn., in response to letters United HealthCare sent to 90,000 plan members while the company was involved in heated negotiations with a group of doctors and hospitals in the state.

United HealthCare renewed the providers’ network contract June 9.

Earlier, in May, the company warned the recipients of the 90,000 letters that they would have to choose new providers by June 10 to receive the highest level of benefits, according to Ohio department officials.

The May letters “were confusing to the recipients, caused unnecessary stress and disruption to the subscribers, members and providers involved, and were misleading,” department officials write in an introduction to a consent order agreed to by United HealthCare of Ohio and United HealthCare affiliates.

United HealthCare and the affiliates have waived rights to challenge the consent order, but they have agreed to the consent order for the purpose of settling the allegations without admitting any violations.

In addition to agreeing to pay the fine and the administrative costs, United HealthCare has sent the 90,000 recipients of the May provider contract termination letters apologizing for the confusion resulting from the sending of those letters, according to the consent order.

United HealthCare and affiliates also have agreed to come up with a plan for avoiding unnecessary stress and disruption resulting from future provider contract terminations.

“We care deeply for our customers and the relationships they have with their doctors,” Robert Falkenberg, chief executive of United HealthCare of Ohio, says in a statement about the settlement. “We have begun retooling our communications process in case of future issues that affect our members and physicians. This is a fair, constructive resolution that will benefit the entire industry and the community.”


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