UnitedHealthcare to pay $1M to New York for failing to cover contraceptives

UnitedHealthcare of New York will pay $1 million to settle allegations it failed to cover contraceptives as required by state law. 

The insurer will also reimburse members who had to pay out-of-pocket for some types of contraceptives, according to a June 20 news release from New York Attorney General Letitia James. 

The attorney general's office opened an investigation into UnitedHealthcare after receiving a complaint from a patient whose oral contraceptive prescription was denied by UnitedHealthcare. Under New York law, insurers must cover FDA-approved contraceptives without copays and without prior authorization or step therapy. 

For therapeutically equivalent contraceptive drugs, insurers must cover at least one form of the drug, according to the release. 

Federal law also requires insurers to cover most contraceptives at no cost to members under the ACA. A federal investigation in October 2022 found that insurers nationwide have excluded or imposed cost-sharing on at least 34 contraceptive products. 

"UnitedHealthcare is committed to women's health, including ensuring the people we serve have timely access to a variety of high-value and affordable FDA-approved contraceptives when they need them," a UnitedHealthcare spokesperson said in a statement shared with Becker's.

"In fact, UnitedHealthcare provides access to more than 150 FDA-approved contraceptive options with $0 cost-share. We apologize for the delay in access to one brand of progestin-only oral contraceptive in New York. We are in the process of resolving these claims with our members."

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