The state is cracking down on four Oregon health insurance companies for denying consumer claims for autism.
The state says Regence BlueCross BlueShield of Oregon and Pioneer Educators Health Trust provided incorrect information about their coverage of autism therapy. United Healthcare could be fined more than $100,000 for denying speech therapy claims to 22 children. And Kaiser Foundation Health Plan is facing a fine of $250,000 for providing misleading information about attorney fees.
Lisa Morawski with the Oregon Department of Consumer Business Services said the action followed complaints. “So we really encourage consumers who are having these types of issues, with getting benefits covered, any kinds of benefits, to call our office and file a complaint.”
United Healthcare said four years ago it performed a routine internal audit and identified an isolated processing mistake affecting six members. The company said it immediately corrected the error, retrained the employee who made the mistake and reimbursed members, with interest, for any medical expenses.
Kaiser Permanente said it's evaluating the order related to informing patients about the disposition of attorneys' fees.
Regence BlueCross BlueShield of Oregon and Pioneer Educators Health Trust said they’re disappointed the state pursued this action without giving them the opportunity to respond.
Oregon’s mental health parity law requires insurers to cover mental health to the same extent they cover physical health.