Another setback for UnitedHealthcare Insurance Company in Nevada lawsuit just days after punitive $60 million verdict | Epstein Becker & Green

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On January 12, 2022, Nevada’s closely watched lawsuit brought by emergency medicine providers against one of the world’s largest health insurance companies, UnitedHealthcare Insurance Company, again caught the attention of hundreds of thousands. of suppliers across the country.

The recent hearing follows a seven-week trial in which the jury found that United and its affiliates deliberately underpaid frontline healthcare workers for emergency medical services. The jury awarded $60 million in punitive damages and $2.65 million in compensatory damages to three affiliates of the Nevada Emergency Physicians Group of TeamHealth, a physician recruitment and services company.

The January 12, 2022 hearing focused on a series of motions submitted by United not to disclose to the public allegedly proprietary information presented during the trial. In an effort to protect this information, United argued that disclosure of its strategic business plans, financials, rate structures and prices, including but not limited to highly contested reimbursement and allowable amounts for these particular medical claims for emergency physicians — would undermine United’s privacy interests. United further claimed that the disclosure would put it at a competitive disadvantage in any future contract negotiations with suppliers.

The court denied United’s motion to seal trial evidence regarding reimbursement rates, authorized amounts and medical claims at issue in the litigation (excluding protected health information). In doing so, Judge Nancy Allf noted that “I have no dog in the fight, but the jury believed the plaintiffs based on this evidence. I just can’t keep this out of the public eye. Notwithstanding this ruling, the Court found that a few of United’s business plan documents should be sealed.

The jury verdict and recent court decision regarding United’s business records is a victory for providers seeking more transparency in how health insurance companies rate its claims against providers. The issues decided in this case are directly relevant and applicable to similar lawsuits that have arisen across the country. We are also in the first month of the new federal law without surprises which took effect on January 1, 2022. This new federal program is also subject to challenges in various courts (as discussed here). It’s important to keep a close eye on these issues as they relate to provider-pays contracts and reimbursement disputes.

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