Business
Maryland insurance commissioner orders United to pay $1.5 million
NEWS IN BRIEF — Posted June 8, 2009
UnitedHealthcare has agreed to reimburse hospitals and radiologists in Maryland $930,000 and to pay $633,000 in fines as penalty for what the Maryland Insurance Administration called noncompliant utilization review policies that placed too heavy a burden on doctors and hospitals.
According to the agreement, an investigation prompted by complaints showed United had not met state requirements for two utilization review programs. The programs are designed to alert the plan when members received elective hospital or radiological care.
According to the agreement, a self-audit by United revealed inappropriate denials of $756,130 in charges in 85 cases to hospitals and $172,599 in 227 cases to radiology groups.
The company did not admit wrongdoing or liability.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/06/08/bibf0608.htm.