Panel Orders UnitedHealth to pay $10.8M for Allegedly Underpaying Physicians

Lawsuit, sue, gavel, court, moneyLawsuit, sue, gavel, court, money

A three-judge arbitration panel in Tampa, Florida, has ordered UnitedHealthcare to pay $10.8 million to a TeamHealth clinician group for underpayments from 2017 until 2020. 

“United persists in exploiting vulnerable patients and refuses to adequately pay providers, despite having faced sanctions, jury awards, and settlement payments of some half a billion dollars,” said Jay Mesrobian, MD, TeamHealth National Medical Director and Chief Clinical Officer in a news release. 

The lawsuit is one of nine cases throughout the country that TeamHealth has brought against United for alleged underpayments. The other eight cases are still ongoing. TeamHealth employs more than 15,000 affiliated healthcare professionals and advanced practice clinicians in a variety of care, including emergency medicine, hospital medicine, critical care, anesthesiology, orthopedic surgery, general surgery, obstetrics, acute behavioral health, post-acute care, post-acute behavioral health and ambulatory care.

According to the news release, the panel found that United had paid TeamHealth physicians 30% of what they were owed as “fair payment” for their care. But UnitedHealth doesn’t view the panel’s ruling as a total loss. TeamHealth was originally seeking $30 million but the panel only ordered UHC to pay $10.8 million, said a UnitedHealth representative through an email who declined to be named.

“The panel appropriately recognized the $30 million-plus TeamHealth was seeking was undeserving and awarded it only a fraction,” the representative said. “It also ruled that TeamHealth’s implied contract and unjust enrichment causes of action had no merit.” 

The company declared that TeamHealth has unrealistic expectations for physician pay. 

“TeamHealth continues to use litigation to distract from the real reason it no longer participates in our network; it expects to be paid double or even triple the median rate we pay other physicians providing the same services. TeamHealth’s actions are driving up the cost of healthcare for everyone,” a UnitedHealth spokesperson said in a statement. 

The company’s spokesperson pointed out that the panel of judges denied TeamHealth’s implied contract and unjust enrichment causes of action. Also, the court rejected TeamHealth’s request for additional prompt pay penalties the day before Thanksgiving, the representative said.

TeamHealth said the fight is not over. “This judgment reflects United’s ongoing, extensive wrongdoing that puts their billions of dollars in record profits ahead of patients’ well-being and the U.S. healthcare system. We will continue to fight United until they change course and start fairly compensating providers,” the company said in a news release.

The contentious legal battle began between the two companies in late 2021 when a Las Vegas jury awarded $60 million in a separate case in punitive damages against United on top of millions in compensatory damages for underpayments on thousands of claims for emergency treatment. 

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