California looking into United's administrative capacity

NEWS IN BRIEF — Posted April 23, 2007

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The California Dept. of Managed Care is investigating whether UnitedHealth Group has sufficient administrative capacity to handle routine tasks such as loading contracts into its system in a timely manner.

The investigation comes after the California Medical Assn. filed a complaint with the department, which regulates health plans, and the California Dept. of Insurance. Aileen Wetzel, CMA's associate director in the center for economic services, said the association wants both agencies to confirm its belief, based on the 400% increase in members' complaints about the company since 2005, that United doesn't have sufficient administrative capacity to meet demand, one of the items established as a condition of the 2005 merger between UnitedHealth Group and PacifiCare Health Systems.

United spokesman Tyler Mason said the company was aware of the issues brought forth by the CMA and had assigned a staff member full time to address the contracting issues. Mason said the company would respond to the managed care department's request in writing.

Managed care department spokeswoman Lynne Randolph said the investigation was ongoing, and any decision that United had committed any violations could result in anything from a formal action plan to handle the administrative problems to fines and penalties.

The California Dept. of Insurance confirmed that it had received CMA's letter but would not comment.

Note: This item originally appeared at

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