This is the reason that private health insurance companies must be regulated. Efforts to exempt them from state laws (which UHC violated in this case) without substituting federal regulations that are as strong or stronger, constitute a recipe for continued injustice.
A pair of St. Louis, Mo-based subsidiaries of UnitedHealthcare will pay $536,000 in fines and review 50,000 chiropractic claims it denied in 2004 in an agreement with Missouri regulators.
Through a settlement between the insurer and the Missouri Department of Insurance, UnitedHealthcare will reexamine the claims filed by chiropractors who treated the company’s policyholders after regulators determined the company violated state law by limiting coverage to 26 visits per year.
In other cases, the insurance department says UnitedHealthcare failed to evaluate the medical necessity of treatment before denying claims. For any chiropractic claims it finds were improperly denied, UnitedHealthcare must reimburse the specialists for those claims, plus interest and in some cases, consumers may have paid the bills, rather than their specialists.
Private sector insurers, if beholden to no one but their shareholders and bottom line, will continue to behave in this manner unless forced by law to do otherwise.
[...] United HealthCare Fined Half a Million Dollars for Illegally Denying Chiropractic Claims. August 27, 2009 by Daniel Redwood, DC · This is the reason that private health insurance companies must be regulated. Efforts to exempt them from …Read More [...]
[...] 40. http://dailyhitblog.com/2009/08/27/united-healthcare-fined-half-a-million-dollars-for-unjustly-denyi… 41. http://www.fiercehealthcare.com/story/unitedhealthcare-pay-250k-fine-ohio/2008-07-29 [...]