It’s another loss for UnitedHealthcare (United) in its ongoing legal battle with TeamHealth. The Tennessee-based emergency physician company has filed a total of ten lawsuits against UnitedHealth Group, but its most recent dispute is all about health plan underpayments from 2017 to 2020. (Are we surprised?)
After a bout in Nevada last December, TeamHealth was awarded more than $60 million in damages after a jury agreed the health plan was systemically underpaying providers – at 80% less than the clinicians billed.
But wait! There’s more. In August 2022, TeamHealth filed again in Nevada, alleging that United used an algorithm to deny care for young children in serious, emergency situations. The lawsuit also claimed that United did not pay the Fremont, Nevada physicians for treating these children. Go figure.
A ruling hasn’t yet been made in that case, but one was recently filed in Florida, where a three-judge arbitration panel ruled late last week that TeamHealth was owed $10.8 million due to underpayments from United from 2017 to 2020, according to an article in Healthcare Finance.
The arbitration panel “relied on convincing evidence that United paid the group 30% of the amount the judges determined to be the fair payment for the care provided – and United today continues to pay at this egregiously low rate,” per a statement from TeamHealth.
Meanwhile, United is throwing stones of its own. In October 2021, United sued TeamHealth in Tennessee, alleging that TeamHealth up-coded claims to a total of $100 million. The case has yet to be adjudicated.
But if United’s recent legal history is any indicator, they would probably do well to remember the adage: don’t throw stones from a glass house.
