New York Attorney General Letitia James has secured a $1 million settlement from UnitedHealthcare of New York, Inc. (UnitedHealthcare) for failing to provide coverage of birth control through its health plans. The Office of the Attorney General (OAG) received a complaint from a Brooklyn patient who was denied coverage for their oral contraceptive by UnitedHealthcare’s Oxford health plan, in violation of New York’s Comprehensive Contraceptive Coverage Act (CCCA). This act mandates that health insurance plans cover FDA-approved contraceptives without copays, restrictions, or delays.
In addition to the penalty, UnitedHealthcare will refund consumers who were denied coverage and had to pay out-of-pocket costs for prescribed birth control. Eligible consumers will receive payment by mail and those with potential claims will be notified and asked to submit a claim. Consumers covered by UnitedHealthcare who paid for contraception and believe they should have been covered in full may submit a claim via email.
“Birth control is an important medication that millions of people use every day,” said Attorney General James. “Denying health insurance coverage of birth control can cause serious health concerns for anyone who takes the medication. Reproductive health care is essential to the safety and wellbeing of New Yorkers, and it is crucial that health insurers abide by New York’s reproductive health care laws.”
The OAG’s Health Care Bureau initiated an investigation into UnitedHealthcare after receiving the complaint about denied coverage under the Oxford plan. The patient's appeal was rejected, requiring prior authorization or step therapy, which delayed access to their birth control and violated the CCCA.
Health insurers that deny or delay coverage impose unnecessary costs on patients and restrict equitable access to reproductive care. Under the CCCA, insurance plans must cover FDA-approved contraceptives without copays and remove any actions limiting access, including prior authorizations or step therapy.
As part of this settlement, UnitedHealthcare will ensure all its health plans cover contraception without copays or delays as required by law. Additionally, staff involved in claim approvals for contraception will be trained on compliance with New York laws.
The settlement also mandates reimbursement for out-of-pocket costs paid by consumers for their birth control since June 1, 2020, plus 12 percent interest. Eligible consumers will receive payments via mail and those with potential claims will be invited to submit them.
This settlement follows other actions taken by Attorney General James to protect reproductive healthcare access. In May 2024, she announced a lawsuit against an anti-abortion group offering medically unfounded treatments and previously worked on shutting down abortion clinic protestors harassing patients. In April 2024, she led a coalition calling on Congress to expand access to IVF.
The matter was handled by Assistant Attorney General Carol Hunt of the Health Care Bureau under Bureau Chief Darsana Srinivasan and Special Counsel for Reproductive Justice Galen Leigh Sherwin.
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