UnitedHealthcare ordered to pay Envision $91M in billing dispute

Arbitrators sided with physician services company Envision Healthcare in its dispute with UnitedHealthcare over allegations the payer breached their contract by reducing reimbursement rates. 

The arbitrators ruled that UnitedHealthcare must pay $91 million in damages, according to a May 2 Envision news release. 

Nashville, Tenn.-based Envision sued UnitedHealthcare in 2018, according to the release. The lawsuit was later moved from federal court to an arbitration panel.

Envision CEO Jim Rechtin said in the release the decision "sets a critical precedent for insurers like UnitedHealthcare to pay in full for the high-quality care its members receive in their most acute time of need." 

The arbitrators will separately assess prejudgment interest and decide Envision’s entitlement to attorney’s fees, costs, and expenses as a prevailing party, according to the release. 

UnitedHealthcare told the Financial Times it disagreed with the decision and said the arbitrators denied many of the claims Envision brought forth. The payer told the outlet it would continue to protect its beneficiaries from the small number of bad actors "who demand unreasonable and anti-competitive rates for their services and drive up the cost of care for everyone." 

UnitedHealthcare has filed its own suit against Envision, claiming the company overcharged the payer by billing for unnecessarily complex care during what should have been routine visits.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months