In the June 24 order, Nancy Allf, district court judge for Clark County, Nev., denied UnitedHealthcare’s motion to dismiss TeamHealth’s amended complaint.
The original complaint was filed against UnitedHealthcare and its subsidiaries in April 2019 by Fremont Emergency Services, part of Knoxville, Tenn.-based TeamHealth. The physicians claimed UnitedHealthcare breached its contract by underpaying claims, and that the insurer worked with third-party claim administrator Data iSight to orchestrate a scheme to artificially reduce payment rates.
“UnitedHealthcare and Data iSight are engaged in a racketeering enterprise and should be held accountable under the Racketeer Influence and Corrupt Organizations Act. This is a step in the right direction for patients and doctors who are being strong-armed by large, highly profitable health insurance companies like United,” a spokesperson from TeamHealth told Becker’s.
In response to the allegations, UnitedHealthcare argued the civil racketeering allegations failed because the alleged underpayment doesn’t have a causal connection to alleged misrepresentations as the physicians are required by law to provide emergency care. The court rejected the argument.
In an emailed statement to Becker’s, a UnitedHealthcare spokesperson said the insurer believes the lawsuit is meritless and intends “to defend ourselves vigorously.”
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