Docs likely to get $200 mil­lion in Unit­edhealth class ac­tion

Modern Healthcare - - LATE NEWS -

Physi­cians in a class-ac­tion law­suit against Unit­edhealth Group over pay­ments for outof-net­work ser­vices could soon start re­ceiv­ing $200 mil­lion in set­tle­ment pay­ments. U.S. Dis­trict Judge Lawrence Mckenna in New York ap­proved dis­tri­bu­tion of the awards, ac­cord­ing to a news re­lease from the Amer­i­can Med­i­cal As­so­ci­a­tion. The money comes from a to­tal set­tle­ment of more than $350 mil­lion be­tween Unit­edhealth and the AMA and other plain­tiffs. That set­tle­ment was pre­ceded by a deal be­tween Unit­edhealth and New York’s then-at­tor­ney gen­eral, An­drew Cuomo. The AMA and oth­ers al­leged that Unit­edhealth sub­sidiary In­genix used flawed data to jus­tify re­im­burs­ing physi­cians for outof-net­work ser­vices at rates lower than what physi­cians were billing, and pa­tients were left re­spon­si­ble for the bal­ance. Unit­edhealth ad­mit­ted no wrong­do­ing in the 2009 set­tle­ment. The set­tle­ment with Cuomo’s of­fice led to the de­vel­op­ment of not-for-profit com­pany FAIR Health—fair is an acro­nym for “fair and in­de­pen­dent re­search”—which pub­licly re­ports out-of-net­work ser­vice rates. Unit­edhealth Group agreed to pay $50 mil­lion to­ward the cre­ation of the FAIR Health data­base and to dis­con­tinue its physi­cian billing in­for­ma­tion data­bases. “The truly last­ing legacy of this court chal­lenge will con­tinue long af­ter the last physi­cian has re­ceived a share of the land­mark set­tle­ment,” AMA Pres­i­dent Dr. Peter Carmel said in the re­lease. Unit­edhealth did not respond to a re­quest for com­ment.

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