Modern Healthcare

Docs likely to get $200 million in Unitedheal­th class action

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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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