TeamHealth has won a legal victory over UnitedHealth Group, but a long-simmering dispute between the two companies continues.
A Florida court ruled this month that America’s largest insurer must pay $10.75 million to settle its underpayment of TeamHealth subsidiary Gulf-to-Bay between 2017 and 2020 Anesthesiology Associates’ allegations. TeamHealth is expected to receive millions of dollars in prejudged interest and fees, according to a press release issued Thursday. The private equity-backed provider group also filed another lawsuit against UnitedHealthcare in the same court, also alleging underpayment, but covering after February 2020.
TeamHealth sentenced to “a small portion” of UnitedHealthcare’s lawsuit against UnitedHealthcare, a spokesman for the company wrote in an email. There are claims of implied contracts and unjust enrichment. Our Network: It is expected to pay double or even triple the median amount we pay other physicians for the same services,” the spokesperson wrote.
A group from Tennessee of emergency physicians began providing outsourced emergency care to hospitals in 1979. Private equity firm Blackstone acquired the company for $6.1 billion in 2017 and has grown it into a leading provider of emergency medicine. TeamHealth employs more than 15,000 Physician working at more than 2,700 facilities, it controls billing for its services.
The company has a history with UnitedHealthcare. The insurer’s claims data is part of a New England Journal of Medicine study with The basis for a landmark study that found that 22 percent of patients who visited an emergency room at a hospital in their insurance network were billed for out-of-network care. The study also found that every time TeamHealth took over a hospital emergency department, Out-of-network costs would skyrocket. Lawmakers often cited the report as justification for passing the No Surprise Act.
UnitedHealthcare argued in court that TeamHealth refused to join its network. sued TeamHealth in federal court in October 2019, alleging that the physician staffing firm defrauded it of paying more than $100 million in fraudulent claims. The case is still pending.
Meanwhile, TeamHealth, which has often argued that UnitedHealthcare underpaid doctors, and its subsidiaries are suing over the alleged underpayments in Arizona, Florida, New Jersey, New York, Oklahoma, Pennsylvania and Texas. Nevada A state jury found UnitedHealthcare to defraud TeamHealth clinicians of $62.65 million in a verdict last December. The downcode and deny claims violated the No Surprises Act. TeamHealth did not seek compensatory damages in this ongoing case, and is hoping to obtain an injunction to end UnitedHealthcare’s use of the technology.
TeamHealth’s national medical director and chief clinical officer, Dr. Jay Mesrobian, said in a news conference: billion dollar settlement. “
