The practices allege that the payer issues drastically low reimbursement rates to force providers out of network, according to the lawsuit. They further allege that once United successfully forces a provider out of network, the payer intentionally underpays the now out-of-network provider, often at rates even lower than the contract rates offered.
The lawsuit also alleges that forcing providers out of network allows United to drive business to its Optum Health subsidiary, according to the report.
The lawsuit is being led by Envision Healthcare, headquartered in Nashville, Tenn. Envision seeks to recover millions of dollars in underpayment for medical care and treatment provided to United members in Florida from Jan. 1 through Dec. 31, 2021, its lawsuit says.
