Optum Behavioral Health Fined For Retroactively Reversing Service Authorizations

On January 31, 2014, the California Department of Managed Health Care (DMHC) fined Optum Behavioral Health $20,000 for denying coverage of preauthorized behavioral health services after the services had been delivered. The DMHC fine applies to Optum’s U.S. Behavioral Plan, California. The DMHC said its examination of claim samples for the period April 1 to June 30, 2011, found that Optum had rescinded service authorization after services were delivered, and that in some cases claims were denied as having no authorization, when in fact a valid authorization had been issued. The DMHC said this represented an unjust . . .