Health

UnitedHealth to Pay $10.75M to Settle TeamHealth Florida Lawsuit

TeamHealth has won a legal victory over UnitedHealth Group, but the longstanding dispute between the two companies continues.

A Florida court ruled this month that the nation’s largest insurance company must pay $10.75 million to clear allegations that TeamHealth subsidiary Gulf-to-Bay Anesthesiology Associates underpaid from 2017 to 2020. release released on Thursday. The private equity-backed provider group also has another lawsuit against UnitedHealthcare in the same court, also alleging underpayment but covering February 2020 and beyond.

TeamHealth received a “share” of what it demanded, with a three-judge panel dismissing allegations that UnitedHealthcare had an implied contract and engaged in unjust enrichment, an insurance company spokesperson wrote in an email. “TeamHealth continues to use litigation to divert attention. for the real reason he is no longer in our network: he expects to be paid double or even triple what we pay other doctors providing the same services,” the spokesperson wrote.

A group of Tennessee emergency physicians founded TeamHealth in 1979 to offer outsourced emergency services to hospitals. Blackstone, a private equity firm, acquired the company for $6.1 billion in 2017 and built it into a leading emergency care provider. TeamHealth employs more than 15,000 physicians in over 2,700 locations where it oversees billing for its services.

The company has a history with UnitedHealthcare. Insurance company claims data provided the basis for the landmark New England Journal of Medicine. study This showed that 22% of the time when patients visit the emergency room at a hospital in their network, they receive bills for out-of-network treatment. The study also found that every time TeamHealth took over the management of a hospital’s emergency department, out-of-network fees skyrocketed. Legislators regularly cited the report as justification for passing the No Surprises Act.

UnitedHealthcare said in court that TeamHealth refuses to join its networks. The insurance company sued TeamHealth in federal court in October 2021, alleging that the staffing firm tricked it into paying more than $100 million in fraudulent claims. This case is ongoing.

Meanwhile, TeamHealth regularly claims that UnitedHealthcare underpays its doctors. The company and its subsidiaries are suing for alleged underpayments in Arizona, Florida, New Jersey, New York, Oklahoma, Pennsylvania and Texas. Last December, a Nevada jury ordered UnitedHealthcare to pay $62.65 million for defrauding TeamHealth doctors.

In July, subsidiary TeamHealth sued UnitedHealthcare in federal court, alleging that the insurer’s use of an algorithm to automatically decode and reject claims violated the No Surprises Act. TeamHealth is seeking no damages in this ongoing case, but is seeking an injunction to stop UnitedHealthcare from using the technology.

“United continues to exploit vulnerable patients and refuses to pay providers adequately despite facing sanctions, jury awards and nearly half a billion dollars in out-of-pocket payments,” said Dr. Jay Mesrobian, National Medical Director and Chief Medical Officer of TeamHealth. news release.


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