Health plan company fined $1M for denying contraceptive coverage

ALBANY — State insurance regulators on Monday slapped Excellus Health Plans with a $ 1 million fine for wrongly denying contraceptive coverage to policy holders.

Investigators from the state’s Department of Financial Services found that between 2008 and 2013 Excellus denied 1,000 claims for contraceptive coverage because of coding errors.

New York State law requires that contraceptive coverage be provided with no copayments, deductibles or any out-of-pocket costs.

The investigation also found that Excellus failed to make timely payments on certain claims and, in other cases, failed to deny claims or address grievances in a timely manner.

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Excellus spokesman Jim Redmond said the company has already addressed the issues raised by the state.

“The key findings in the report relate to items from a few years ago,” Redmond said. “Those issues were addressed when we completed a major transformation project which consolidated several computer platforms down to one. The changes we made have brought about significant improvements to our claims payment system.”

The investigation of Excellus is part of wide ranging probe of the insurance industry’s handling of contraceptive claims that was launched by the state after a February sting operation found that many insurers were providing inaccurate information to consumers.

“The steps taken today by the Department of Financial Services make good on our promise to women across the state and send a clear message that all insurance companies who attempt to deny or inhibit access to women’s health care will be held accountable,” Gov. Cuomo said in a statement.

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