Class-Action Lawsuits
HORIZON
UnitedHealth Group (UCR) Settlement
Class-Action Settlement Against
UnitedHealth Group
ATTENTION: Physicians Who Provided Out-of-Network Services
to Patients Covered by UHG
In mid-April 2010, the
national class-action settlement administrator for the UnitedHealth Group UCR
settlement began mailing notices to
physicians who provided out-of-network services to its members. If you rendered
these services and did not receive this notice, MSNJ urges you to contact the
settlement administrator and/or to download the notice for details.
This national class-action lawsuit was filed by the American Medical Association
and the New
York and Missouri Medical Societies a decade ago. It
alleged a price-fixing scheme used by UnitedHealth Group and other insurers to
underpay physicians and patients for out-of-network care through use of the
downward skewed Ingenix database of fees. Ingenix is a UnitedHealth Group
subsidiary.
The New York Attorney General (NYAG), Andrew Cuomo,
first reached a settlement with United Healthgroup in which it agreed to pay $50
million toward the establishment of a new, independent database to be used by
health insurers to determine rates for out-of-network fees. Ingenix agreed to
give up the UCR database. The day after the NYAG settlement agreement, the
national class-action was settled for $350 million.
Physicians
who provided covered out-of-network services between March 15, 1994 and November
18, 2009, to patients covered by a health plan insured or
administered by the defendants, UnitedHealthcare,
Oxford Health Plans, Metropolitan Life Insurance Company, and others, are
members of the class. In addition, physicians who billed one of the defendants
during this time period through an assignment of benefits (checking “yes” on
box 13
of the HCFA/CMS 1500 form) are members of the class. Class members are eligible
to file a claim for a portion of the $350 million settlement fund. All
physicians, regardless of class membership, will benefit from an independent
database used to establish out-of-network fees.
The following are
court-imposed deadlines that physicians must
follow:
- July 27, 2010—Deadline for filing
objections to the settlement or for opting-out of the settlement;
- September 13, 2010—Date for the
final settlement hearing to consider any filed objections; and
- October 5,
2010—Deadline for filing a claim to share in the settlement fund.
Read the Frequently Asked Questions for details on this
settlement agreement. Read the Step-by-Step
Guide to maximize your recovery under the settlement
agreement.
Plan to attend a seminar on How to File a Claim to receive your
fair share of the settlement fund on June 22 at MSNJ.
Visit the AMA’s web site
for on-line
resources.
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