San Antonio, Texas-based Baptist Health System has filed a lawsuit against UnitedHealthcare over alleged underpayments for emergency room services provided to patients with ACA coverage, the San Antonio Express-News reported Jan. 2.
The health system’s hospitals are not in network with UnitedHealthcare’s exchange plans but are required under federal law to provide emergency care regardless of a patient’s coverage or ability to pay. The lawsuit, filed Dec. 22 in state district court, alleges UnitedHealthcare has reimbursed the hospitals at rates “substantially below” the typical charges for those services, according to the report.
Baptist, which operates seven acute-care hospitals and five neighborhood hospitals in the San Antonio area, is seeking more than $1 million in reimbursements. The two sides attempted to mediate disputes over 108 claims last year but were unable to reach an agreement, according to the report.
