Panel Orders UnitedHealthcare to Pay $10.8M for Allegedly Underpaying Physicians

Lawsuit, 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.

Based in Knoxville, 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.

“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 Dr. Jay Mesrobian, TeamHealth National Medical Director and Chief Clinical Officer in a news release. [deleted MD. we don’t add Md or mba or any title. if they are a practicing physician they get a Dr.]

According to the news release, the panel found that UnitedHealthcare had paid TeamHealth physicians 30% of what they were owed as “fair payment” for their care.

The lawsuit is one of nine cases throughout the country that TeamHealth has brought against UnitedHealthcare [let’s not use United even if teamhealth is using it. You can use UHC or UnitedHealthcare] 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.

Despite the panel’s decision, UHC does not view the panel’s ruling as a total loss. TeamHealth was originally seeking $30 million but the panel only ordered the insurance giant to pay $10.8 million, said a UnitedHealth representative 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 UHC representative said in an emaill. “It also ruled that TeamHealth’s implied contract and unjust enrichment causes of action had no merit.

Further, the representative forwarded a statement that 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,” the statement said.

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

Meanwhile, TeamHealth does not believe 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 US healthcare system. We will continue to fight United until they change course and start fairly compensating providers,” the company said in a news release.

TeamHealth and UnitedHealthcare’s legal battle dates back to a separate case in which in late 2021 the Las Vegas jury awarded $60 million to TeamHealth

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 in a separate case against UnitedHealthcare on top of millions in compensatory damages for UnitedHealthcare’s underpayments on thousands of claims for emergency treatment.

Photo: photovs, Getty Images

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