A class-action lawsuit filed Sept. 7 accuses UnitedHealth of failing to fairly reimburse out-of-network providers by bypassing rates established by vendor contracts.
Specifically, the lawsuit points to member experiences that allege UnitedHealth ignored discounted rate agreements between vendors and providers, allegedly violating vendor contract plans.
The move is a violation of the Employee Retirement Income Security Act of 1974, the lawsuit alleges, as the uneven application of rates benefits the insurer and its employer customers, not members.
The plaintiffs include three health plan members whose coverage is either administered or underwritten by UnitedHealthcare, all of whom are representing similar parties.
"We are committed to helping people access the care they need, and reimbursing care providers, including out-of-network providers, consistent with the terms of members’ benefit plans," UnitedHealth wrote in an emailed statement. "We will defend ourselves in this case."
The complaint received a court summons Sept. 8.