North Carolina Insurance Commissioner Mike Causey has fined UnitedHealthcare $3.4 million for violations in claims handling practices involving balance billing, the state Department of Insurance announced last week.
The fine stems from a four-year investigation that revealed UnitedHealthcare failed to protect members from unexpected out-of-network charges, particularly in emergency room and anesthesia services.
Investigators found the insurer did not consistently follow its own procedures to negotiate with providers and prevent members from bearing excessive financial burdens. The investigation began after sustained complaints from members and health care providers.
Specific violations included subjecting members to cost-sharing beyond standard deductibles, copayments, and coinsurance for medically necessary services performed by out-of-network providers at in-network facilities.
Read the full story on wcnc.com.
