Physicians will soon be able to get their share of a $350 million settlement with UnitedHealth Group. The settlement is the result of a class action lawsuit, initially filed in 2000 by AMA and other health care provider and patient groups, alleging that United conspired to defraud consumers by manipulating out-of-network reimbursement rates and shortchanging physicians and patients by hundreds of millions of dollars over the past 15 years.
Physicians will be paid based on their total “recognized loss” between 1994 and 2009, which is calculated based on the difference between a physician’s billed amount and the “allowed amount” that United actually paid for covered out-of-network services. If the total amount of submitted claims exceeds the settlement fund, physicians will receive a pro rata share based on their total recognized loss.
A hearing to determine final approval of the settlement is set for September 13 in U.S. District Court in New York. Doctors have until July 27, 2010, to file any objections to the settlement or opt out. The deadline to submit claims for payment from the settlement fund is October 5, 2010.
To help physicians understand the settlement and what they need to do to claim their share, CMA has published this settlement guide and compiled other useful resources (listed below).
If you have any questions, please contact CMA’s member help center at 800/786-4CMA (4262) or memberservice@cmanet.org.
Other UnitedHealth Group Settlement Resources: