UnitedHealthcare is suing Radiology Partners and its Arizona affiliate, alleging the companies have been gaming the No Surprises Act’s independent dispute resolution process and “funneling millions into the pockets of its private equity owners.”
In a complaint filed Aug. 8 in the U.S. District Court of Arizona, UnitedHealthcare accuses the radiology practice of “abusing” the IDR process by routing in-network claims through Sonoran Radiology to make them appear out-of-network, then initiating the IDR process for tens of thousands of claims.
“This pattern of bad behavior not only undermines the integrity of the IDR system but also drives up healthcare costs for everyone,” a UnitedHealthcare spokesperson said in a statement to Becker’s. “We are committed to protecting our members and customers from harmful practices by a small number of private equity-backed providers.”
The No Surprises Act took effect in January 2022 with the goal of preventing surprise billing by implementing the IDR process for payment disputes between payers and out-of-network providers. Providers win the majority of disputes, with median payment determinations often ranging from 300% to 400% above the qualifying payment amount since 2023. Radiology Partners accounted for 28% of resolved line-item claims in 2023 and 2024, according to a study published Aug. 25 in Health Affairs.
According to the lawsuit, Radiology Partners acquired multiple Arizona practices, including Scottsdale Medical Imaging in 2017 and Sun City Imaging in 2018. The practices held contracts with UnitedHealthcare. In 2019, the company formed Red Rock Imaging Associates, later renamed Sonoran Radiology, and obtained separate billing credentials. Beginning in 2021, UnitedHealthcare alleges that services performed by physicians at the acquired in-network groups were billed under Sonoran’s out-of-network tax ID, and the claims were then challenged once the No Surprises Act took effect.
“Radiology Partners (RP) firmly denies the allegations in UnitedHealthcare’s (UHC) lawsuit,” a spokesperson said in a statement to Becker’s. “This is yet another example of a broader and troubling trend: When payers lose in the federal No Surprises Act arbitration process, they turn to litigation. UHC’s complaint misrepresents the facts and distracts attention from its repeated failures to pay healthcare professionals despite federal protections. RP-affiliated practices follow federal guidelines and have consistently prevailed in the independent dispute resolution process, underscoring the validity of our claims. We remain focused on delivering high-quality radiology care and supporting our radiologists, clients and patients. RP will vigorously defend against these claims and continue advocating for fair, lawful reimbursement practices that protect patients’ access to care. We look forward to presenting the full facts in our formal court filing.”
The lawsuit seeks to overturn past arbitration awards, recover damages and obtain a declaration that UnitedHealthcare is not required to pay Sonoran for services performed by physicians at other Radiology Partners groups. The complaint, which includes RICO Act accusations and 12 counts ranging from fraud and negligent misrepresentation to civil conspiracy and unjust enrichment, also demands a jury trial.
Radiology Partners and UnitedHealthcare have been entangled in multiple legal disputes in recent years. In 2024, an arbitration panel vacated a $134 million judgment that had previously been awarded to the radiology group.
