Medica to pay $300,000 fine for violating mental health parity laws

Medica Insurance Company will have to pay $300,000 and be monitored by the Minnesota Department of Commerce for two years after officials discovered the company violated mental health parity laws, the department announced on Wednesday.

As a result of what’s known as a market conduct exam, the Department of Commerce alleged Medica infringed on mental health laws that are in place to guarantee that coverage for mental health care is similar to coverage for medical or surgical care.

The news release from the Department of Commerce stated that Medica violated those laws by “paying providers more for medical or surgical procedures than for mental health or substance abuse disorder treatment.” The department also found that Medica was stricter in evaluating mental health claims than medical or surgical claims and that the company inadequately completed explanation of benefits statements for mental health.

Medica is now required to improve its mental health coverage process, which the Department of Commerce will monitor over a two-year period, according to the release. Medica must also pay a $300,000 fine due to the department’s findings.

“Commerce’s action with Medica underscores our mission to protect the interests of Minnesota consumers and to ensure that all insurers abide by the law,” Commerce Commissioner Grace Arnold said. “Access to mental health care has never been more important. We are committed to removing barriers Minnesotans face when accessing mental health and substance abuse care.”

The order marks the second enforcement against a major health insurer in two months. In May, the Department of Commerce took similar action against HealthPartners, ordering the health insurer to pay $150,000.

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A representative from Medica Insurance Company responded to 5 EYEWITNESS NEWS’ request for comment, saying, “We are committed to ensuring those who need mental health care have access to the providers and services that can best support their needs. We support the State’s goal of mental health parity and are committed to working to ensure we’re collectively supporting Minnesotans.”