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Panel Orders UnitedHealthcare to pay $10.8M for Allegedly Underpaying Physicians – MedCity News

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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. 

According to the news release, the panel found that UnitedHealthcare (UHC) 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 UHC for alleged underpayments. The other eight cases are still ongoing.

Despite the panel’s decision, UHC doesn’t 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 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 email. “It also ruled that TeamHealth’s implied contract and unjust enrichment causes of action had no merit.” 

Further, the representative forwarded a statement that 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 pointed out that the panel of judges denied TeamHealth’s implied contract and unjust enrichment causes of action. Also, they 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 U.S. healthcare system. We will continue to fight United until they change course and start fairly compensating providers,” the company said in a news release.

The contentious legal battle between the two companies began with a separate case in which a Las Vegas jury in late 2021 awarded $60 million to TeamHealth. That award included punitive damages on top of millions in compensatory damages for UHC’s underpayments on thousands of claims for emergency treatment.

Photo: photovs, Getty Images

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