$24M Ruling Against UnitedHealth May Enhance Payors' Scrutiny of In-Network Providers

A Nevada jury has ruled that two affiliates of UnitedHealth Group must pay $24 million in damages for negligent oversight of a physician who gave two patients hepatitis C through unsterile care, according to a Bloomberg report.

The jury ruled that officials from Health Plan of Nevada and Sierra Health Services improperly monitored Dipak Desai, MD, a former gastroenterologist who has been blamed for infecting patients after he reused vials of anesthesia and failed to sterilize equipment. The plaintiffs' contractions were part of a 2007 outbreak, in which Nevada officials notified 50,000 patients they may have been infected with hepatitis C from Dr. Desai's practice.

Minnetonka, Minn.-based UnitedHealth has been ordered to pay $9 million to one of Dr. Desai's former patients and another $15 million in compensatory damages to another former patient and her husband. The health insurance company has said the jury's ruling creates a "dangerous precedent," as it holds payors responsible for the actions of individual providers, according to the report.

The plaintiffs alleged UnitedHealth did not properly monitor Dr. Desai's practice, even though it had received complaints about his care. They also said the health insurer was aware of Dr. Desai's reputation for careless practice but still gave him a contract to perform colonoscopies in an HMO network and did not check on the quality of his care.

UnitedHealth's attorneys have said there were procedural issues with the case. The attorneys claimed the judge wrongfully prevented them from fully defending their client against the plaintiffs' claims by prohibiting jurors from hearing certain evidence, according to the report.

In a Thomson Reuters report, UnitedHealth attorneys said they plan to appeal the jury's verdict.

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