Centene underpaid physicians affiliated with TeamHealth, court says

Centene Corp. and its subsidiaries underpaid a group of emergency room physicians who are part of TeamHealth, according to an Aug. 18 verdict.

The verdict concerns a lawsuit that TeamHealth subsidiary Southeastern Emergency Physicians filed against Centene and its affiliates Ambetter and NovaSys Health in 2017. The lawsuit alleged the health insurers significantly underpaid Southeastern Emergency Physicians for ER care.

Under the verdict, a six-person jury in the U.S. District Court for the Eastern District of Arkansas found Centene and its subsidiaries breached their contract with Southeastern Emergency Physicians by underpaying ER claims and delaying reimbursement. The jury found Centene and its affiliates are liable for $9.4 million in underpayments to the ER physicians.

TeamHealth CEO Leif Murphy said in a news release that "Centene's actions are all too common on the part of payers. Large and profitable health insurance companies are using their market power to systematically underpay doctors, cancel contracts, and further boost their record profits."

In an emailed statement to Becker's, Centene affiliate NovaSys said, "We disagree that NovaSys breached the contract, and we plan to appeal. All of the health insurance claims at issue have already been paid at the appropriate rate for ACA claims."

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