UnitedHealthcare loses to TeamHealth — again — over alleged underpayments

A three-judge arbitration panel in Florida ruled that UnitedHealthcare must award $10.8 million to a TeamHealth clinician group for underpayments from 2017 to 2020. 

The verdict is the latest in a contentious legal history between the payer and the Knoxville, Tenn.-based physician staffing company. A jury ruled in December 2021 that UnitedHealthcare must pay $60 million in punitive damages after losing a Nevada lawsuit against TeamHealth over thousands of provider underpayments for emergency services. TeamHealth medical groups have eight additional lawsuits pending across the country challenging the payer's alleged underpayment practices, according to a Nov. 30 TeamHealth news release. 

In October 2021, UnitedHealthcare sued TeamHealth in a Tennessee federal court for allegedly upcoding claims to deceive the payer into overpaying for emergency services. The lawsuit claims United overpaid $100 million on claims submitted by TeamHealth since 2016. In May, the judge refused TeamHealth's request to dismiss the lawsuit. 

TeamHealth said in the Nov. 30 release it anticipates an additional award of millions of dollars in prejudgment interest and cost.

"This judgment reflects United's ongoing, extensive wrongdoing that puts their billions of dollars in record profits ahead of patients' well-being and the U.S. healthcare system," Jay Mesrobian, MD, a TeamHealth national medical director and chief clinical officer, said in the release. "We will continue to fight United until they change course and start fairly compensating providers." 

In a Dec. 1 email to Becker's, a UnitedHealthcare spokesperson said the panel issued "a compromise decision, awarding TeamHealth only a fraction of what it was undeservingly seeking."

"The panel appropriately recognized the $30 million-plus TeamHealth was seeking was undeserving and awarded it only a fraction," the spokesperson said. "It also ruled that TeamHealth’s implied contract and unjust enrichment causes of action had no merit. TeamHealth continues to use litigation to distract from the real reason it no longer participates in our network; it expects to be paid double or even triple the median rate we pay other physicians providing the same services. TeamHealth’s actions are driving up the cost of health care for everyone."

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