Optum faces antitrust lawsuit from California health system

Covina, Calif.-based Emanate Health is accusing UnitedHealth Group's Optum of pressuring the system not to compete with Optum in the primary care business, and of steering patients away from their physicians who left Optum to join Emanate's practices. 

On Nov. 20, Emanate Health filed a lawsuit in federal court in California accusing Optum of anticompetitive practices, including a "concerted effort to prevent patients from contacting their doctors who chose to leave [Optum] to join competing medical groups."

"Emanate Health, Emanate Health Medical Group and Emanate Health Independent Physicians Association have taken joint legal action to protect the rights of our respective patients, physicians and employees," a spokesperson for the system said in a statement shared with Becker's. "Good faith efforts to resolve these issues with Optum have been rebuffed or met with retaliation. We continue to focus our efforts on helping people keep well in body, mind and spirit by providing quality healthcare services in a safe, compassionate environment." 

According to court documents, several physicians employed at an Optum-owned clinic in Covina left to join Emanate Health in and after December. Optum then transferred patients to other Optum-affiliated physicians without informing them of their physicians' departure, Emanate Health alleged in its complaint. 

The health system alleged Optum instructed its employees not to inform patients their physicians had moved practices, telling patients their physicians had retired or were on vacation. 

"It is one thing if a [patient] is given the information needed to knowingly choose who will be his or her physician when the doctor changes employers. It is quite another for [Optum] to lie to patients and deliberately conceal the circumstances and whereabouts of the patients' established physicians," the system said in its complaint. 

Emanate Health also alleged that Optum pressured the system to stay out of the primary care business. Optum did not renew its hospital service agreement contracts with Emanate's three hospitals for its commercial and Medicare Advantage HMO members after the system did not agree to limit its primary care business, the system said in court documents.  

"These are baseless assertions related to a contractual dispute in a highly competitive market, and we will defend ourselves vigorously," an Optum spokesperson said in a statement shared with Becker's. 

The cancellation of the contracts has led to a "significant decline" in admissions at Emanate Health's hospitals, the system alleges. 

Optum is the largest employer of physicians in the U.S., with more than 70,000 employed or affiliated physicians across more than 2,000 locations. 

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