Payers have faced state penalties in 2026 for slow reimbursements, mishandled member complaints, and mental health parity violations. Fines in 2025 are here.
Payers fined by states in 2026:
- Five insurers — Aetna, Cigna, Molina’s ConnectiCare, UnitedHealthcare and Anthem — were fined by Connecticut for an unknown amount in April over mental health parity violations.
- Cigna was fined $80,000 by Maryland in March after regulators determined a newly enacted automatic downcoding policy was not allowed under state law.
- Aetna was fined $550,000 by Pennsylvania in March following a market conduct exam that found violations in mental health parity laws.
- Anthem BCBS Virginia was fined $118,000 by the state in March after regulators determined it and another subsidiary failed to include required minimum fair business standards provisions within provider contracts. The companies also paid $346,000 in restitution to 1,680 consumers and 586 providers.
- EmblemHealth was fined $2.5 million in February after an investigation by the New York attorney general’s office found the insurer violated parity laws and failed to ensure access to mental healthcare services because of inaccurate provider directory listings.
- Centene’s Health Net was fined $1.3 million by California in February “for mishandling payment disputes from doctors, hospitals and other providers.”
- Anthem Blue Cross was fined $15 million by California in January due to “longstanding and widespread failures” with handling member complaints
- 11 insurers were fined nearly $25 million by Georgia in January for violating state mental health parity laws, including Oscar, Anthem, Kaiser, Cigna, Aetna, Humana, UnitedHealthcare, CareSource, and Alliant Health Plans.
- Memorial Hermann Health Plan was fined $130,000 by Texas in January after regulators determined the insurer violated state law across multiple areas including prior authorization, claims processing, complaint handling, provider directory accuracy, and mental health parity reporting.
- Kaiser Foundation Health Plan was fined $300,000 by Washington state in January for failing to comply with federal mental health parity requirements, though $100,000 of that amount was suspended.
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