3 suits filed against UnitedHealth: What ASCs need to know

Three lawsuits have been filed against healthcare giant UnitedHealth Group and UnitedHealthcare in the last month — including two ASCs filing suits. 

The three suits:

1. Envision Healthcare claims UnitedHealth Group is forcing physician groups out of the network in an attempt to recruit them to its subsidiary Optum. Envision, a physician services company and parent company of ASC management company AmSurg, accused United in a lawsuit of forcing providers to take drastically reduced reimbursement rates during contract negotiations, or forcing them out of the network. Then, United allegedly pays providers for out-of-network care at rates lower than the company offered for in-network providers.

2. Advanced Surgery Center in Fort Lee, N.J., filed a lawsuit against UnitedHealthcare for allegedly failing to pay for hernia-related procedures. Working on behalf of a patient with an Employee Retirement and Income Security Act plan, the ASC sought preauthorization for the surgical services. 

3. Surgery Center of Viera in Melbourne, Fla., filed a lawsuit against UnitedHealthcare for alleged repricing and underpayment of a spine surgery performed in 2019. The ASC, which includes neurosurgeon Ara Deukmedjian, MD, and interventional pain management specialist Bharat Patel, MD, operated on a patient who was insured through the Brookdale Senior Living Welfare Plan, which is administered by UnitedHealthcare, according to court documents. The surgery center received authorization to perform the services on the patient but was paid only $16,125.56 on a final bill of $193,438, according to the complaint.

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