UnitedHealthcare to pay TeamHealth $10.8M for alleged underpayments: What ASCs need to know

An arbitration panel in Florida has ruled that UnitedHealthcare must pay a TeamHealth clinician group $10.8 million for alleged underpayments from 2017 to 2020. 

Here's what ASCs need to know:

1. The verdict comes after a jury ruled in December 2021 that UnitedHealthcare must pay $60 million in punitive damages following a lawsuit physician staffing firm TeamHealth filed against the payer over thousands of provider underpayments for emergency services. 

2. There are currently eight additional pending lawsuits challenging the alleged underpayments. 

3. In October 2021, UnitedHealthcare sued TeamHealth for allegedly upcoding $100 million worth of claims for emergency services since 2016. In May, a judge refused to dismiss the suit. 

4. In a Nov. 30 release shared with Becker's, TeamHealth medical groups anticipated an additional award of millions of dollars in prejudgment interest and cost. 

5. A UnitedHealthcare spokesperson told Becker's in a Dec. 1 email that the panel issued "a compromise decision, awarding TeamHealth only a fraction of what it was undeservingly seeking."

"It also ruled that TeamHealth's implied contract and unjust enrichment causes of action had no merit," the spokesperson said. "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."

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