The hospitals claim that UnitedHealthcare consistently reimbursed them at rates far below the amount required by law, beginning in 2022. The lawsuit, filed on Feb. 14 in the Ninth Judicial Circuit Court of Florida, is seeking damages to recover the underpaid amounts, which have been calculated to allegedly exceed $145 million.
The plaintiffs argue that they have provided emergency services to more than 5,000 UnitedHealthcare members, despite being out-of-network with the insurer. Under federal and state law, the hospitals are obligated to provide emergency care without regard to a patient’s ability to pay or their insurance network status. In return, the plaintiffs claim that UnitedHealthcare is required to reimburse for the services at the lesser of the hospital’s charges or the usual and customary rates for similar services in the community.
The hospitals involved in the lawsuit:
- Osceola Regional Hospital
- Central Florida Regional Hospital
- Poinciana Medical Center
- Oviedo Medical Center
- UCF Lake Nona Hospital
- Marion Community Hospital
- Putnam Community Medical Center
- North Florida Regional Medical Center
- Notami Hospitals of Florida (Lake City Hospital)
- West Florida Regional Medical Center
- Fort Walton Beach Medical Center
- Tallahassee Medical Center
- Okaloosa Hospital (Twin Cities Hospital)
- Bay Hospital (Gulf Coast Hospital)
- Lawnwood Medical Center
- Okeechobee Hospital (Raulerson Hospital)
- St. Lucie Hospital
