Editor's note: This article was updated with additional comments from UnitedHealthcare.
A panel of judges in Florida ruled this week that UnitedHealthcare must pay TeamHealth $10.8 million for underpayments, the latest round in the companies' ongoing legal bout.
The Tampa-based arbitration panel awarded TeamHealth the damages for "egregious" underpayments from 2017 to 2020 to a local clinical group, the physician staffing giant said in an announcement late Wednesday. TeamHealth said it anticipates "an additional award of millions of dollars in prejudgment interest and costs" to come, as the judges ruled UHC paid just 30% of the rate they deemed fair for the services provided.
TeamHealth said UnitedHealth continues to pay this rate today.
“United persists in exploiting vulnerable patients and refuses to adequately pay providers, despite having faced sanctions, jury awards, and settlement payments of some half a billion dollars,” said Jay Mesrobian, M.D., a TeamHealth national medical director and chief clinical officer, in the release. “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. We will continue to fight United until they change course and start fairly compensating providers.”
In a statement to Fierce Healthcare, UnitedHealthcare noted that TeamHealth was seeking more than $30 million in damages, and that the panel awarded the provider significantly less.
“The panel appropriately recognized the $30 million-plus TeamHealth was seeking was undeserving and awarded it only a fraction," a 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.”
The nation's largest insurer and TeamHealth have spent several years in battle in the courtroom. The companies engaged in heated contract disputes, and TeamHealth affiliates have filed lawsuits against UHC in multiple states over reimbursement rates.
In October 2021, UnitedHealth also sued TeamHealth in Tennessee, alleging the insurer upcoded claims to the tune of $100 million. In May of this year, a federal judge denied TeamHealth's attempt to have the Tennessee case dismissed.
In November 2021, a Nevada jury ruled against UHC, deciding the insurer underpaid TeamHealth's clinicians. The jury awarded TeamHealth $60 million in punitive damages. TeamHealth filed another lawsuit in Las Vegas in July, seeking an injunction for UnitedHealthcare's downcoding policy, arguing that the 2021 ruling did not change UnitedHealth's behavior.
UHC has a similarly contentious relationship with Envision Healthcare, another physician staffing firm. The insurer cut Envision from its network in 2021, arguing that Envision did not charge fair market rates for its services. The two companies sparred in dueling lawsuits filed in September.