Centers for Medicare & Medicaid Services (CMS) fines UHC $2.5M over inaccurate Medicare denials, delays
In accordance to the Star Tribune, CMS has fined the Minnetonka, Minn.-based UnitedHealthcare (UHC) with $2.5 million after an audit discovered systemic compliance issues with its Medicare health plans that led beneficiaries to experience delayed or denied access to the prescription drug coverage.
The insurer's May 2016 operations were examined by the scheduled audit and whether UnitedHealthcare (UHC) complied with the established rules for the Medicare Part D prescription drug plans. UnitedHealthcare is believed to be one of 17 insurers confronting fines ranging from the $32,000 to $2.5 million for compliance problems discovered in the audits of Centers for Medicare & Medicaid Services (CMS).
In a Nov. 22 letter, Federal officials claimed that in the case of UnitedHealthcare, "some of the denials were for prescription drugs that are utilized to treat acute conditions that need quick and immediate treatment," the report states. Moreover, some beneficiaries observe higher out-of-pocket charges.
In a statement, UnitedHealthcare (UHC) stated that it "instantly addressed the findings of this planned audit, which occurred previous year," and is "committed to assisting our members with the care they need, when they need it."