CMS identified violations of Part D formulary and benefit administration requirements that resulted in UnitedHealth’s enrollees experiencing inappropriate denials of and/or delayed access to Part D prescription drugs at the point of sale. UnitedHealth’s violations include:
UnitedHealthcare is not changing its coverage of treatment for gender dysphoria as a result of the preliminary injunction issued on Dec. 31, 2016, by the U.S. District Court in Texas. UnitedHealthcare Employer & Individual coverage of treatment for gender dysphoria will remain consistent with the members’ applicable benefit plan language.
Next year UnitedHealthcare will offer individual plans through the Exchange in a limited number of states. This change in market footprint reflects our longstanding goal to offer products that are both affordable for consumers and financially sustainable for our company.