The Connecticut Insurance Department fined Aetna, Cigna, ConnectiCare, UnitedHealthcare and Anthem over alleged mental health parity violations, according to an April 15 department report.
The report said carriers had “non-comparable and inadequate [mental health and substance use disorder] networks because of more stringent and limiting reimbursement rate structures demonstrated through disparate reimbursement rates, disparate out-of-network utilization rates, disparate new patient acceptance rates and disparate patient wait times,” which allegedly violated the Mental Health Parity and Addiction Equity Act.
Four of the five insurers committed additional violations, the report alleged, due to “incomplete, insufficient, inaccurate or not updated network access measures regarding the new patient acceptance rate and patient wait times.” The report did not name the four insurers.
The report also said carriers were unable to link disparate outcomes to nonquantitative treatment limitations, the non-numeric standards insurers use to manage access to care. Both Aetna and Anthem argued case management is not an NQTL and therefore beyond the parity law’s scope.
The department did not outline the size of the fines, but a 2025 Connecticut law strengthened the state’s ability to penalize insurers.
“The department is actively engaging with each carrier through established processes to address identified concerns and ensure compliance with state and federal parity requirements,” an April 22 news release accompanying the report said. “Penalties will be determined based on the nature, severity and duration of violations, as well as prior compliance history, and will be finalized through established administrative enforcement processes. The department may take additional regulatory action, as necessary.”
The report did acknowledge ConnectiCare’s secret shopper audit program, which checks in with providers to gather real-time data on new patient acceptance rates and wait times.
As states take on more responsibility with enforcing mental health parity, these fines are among the latest hitting insurers. Aetna, Cigna, Elevance Health and UnitedHealthcare are not strangers to these actions.
The Connecticut Association of Health Plans said its members are reviewing the findings.
“While there may be different perspectives on how certain standards are applied in practice, carriers remain committed to working collaboratively with the department of insurance, policymakers, providers and patient advocates to advance mental health parity in a way that is practical, sustainable, and centered on the needs of Connecticut patients and families,” a spokesperson said. “CTAHP members remain focused on understanding the department’s conclusions and identifying constructive paths to compliance with federal and state requirements.”
Becker’s contacted all five insurers and will update this story if more information becomes available.
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