UnitedHealth Faces $1.3 Billion in Fines

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California regulators are expected to announce today that they are seeking as much as $1.33 billion in penalties from Cypress-based PacifiCare as a result of widespread problems stemming from its takeover two years ago by healthcare giant UnitedHealth Group Inc., the Los Angeles Times rerpots


In an investigation prompted by widespread complaints, the state Department of Insurance uncovered 133,000 alleged violations of state laws and regulations regarding payments for medical care. Each violation carries a maximum penalty of $10,000 for a possible total of $1.33 billion.


Separately, the state Department of Managed Health Care alleged that 30% of the medical claims it reviewed were improperly denied. That agency is seeking an additional $3.5 million in fines.

“These were very serious violations,” said Cindy Ehnes, executive director of the Department of Managed Health Care. “The most fundamental promise of insurance is that they will pay when you are sick, and they will pay those physicians and hospitals in a fair manner.”


Insurance Commissioner Steve Poizner expressed frustration at efforts to get the company to make changes.


Read the full L.A. Times story

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