NEW YORK – New York Attorney General Letitia James announced a settlement with UnitedHealthcare, the nation's largest health insurer, requiring the company to pay a $1 million penalty for violating the state's Comprehensive Contraceptive Coverage Act (CCCA).
The insurer was found to have failed to provide coverage for birth control as mandated by the CCCA, which stipulates that health insurance plans must cover FDA-approved contraceptives without copays, restrictions, or delays.
The settlement follows a complaint from a Brooklyn patient who was denied coverage for oral contraceptives by UnitedHealthcare's Oxford health plan. The patient’s subsequent appeal was rejected, and the plan insisted on prior authorization or step therapy, which led to the patient going without the medication and prompted an investigation by the Office of the Attorney General (OAG).
As part of the agreement, UnitedHealthcare will refund consumers who were denied coverage by any of its health plans and had to pay out-of-pocket for their prescribed birth control. These consumers will receive payment in the mail, and those with potential claims will be contacted and asked to submit a claim.
Reimbursements will include the out-of-pocket costs plus 12 percent interest for claims dating back to June 1, 2020. UnitedHealthcare is also required to ensure compliance with the CCCA across all its health plans moving forward.
The OAG's action underscores the importance of accessible reproductive health care and the enforcement of laws designed to protect consumers from undue costs and barriers to care. This settlement is part of Attorney General James's broader commitment to safeguarding reproductive health rights, as evidenced by previous legal actions against anti-abortion groups and advocacy for expanded access to reproductive services.
Affected consumers covered by UnitedHealthcare who paid for contraception and believe they should have been covered in full may submit a claim by emailing UHC_NYContraceptives_support@uhc.com. The settlement ensures that UnitedHealthcare will train staff involved in the claim approvals process for contraception on compliance with New York laws.
This settlement is based on a press release statement from the Office of the New York State Attorney General.
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