UnitedHealth used $1B+ from employer plans to settle payment disputes, lawsuit says

UnitedHealth Group used more than $1.3 billion from employer-based plans to settle payment disputes with physicians through a practice known as “cross-plan offsetting,” according to a new lawsuit.

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Cross-plan offsetting is a billing tactic that aims to offset overpayments made to providers from one of an insurer’s health plans by withholding payments to the same provider from a different health plan it manages.

The class-action lawsuit, filed in the U.S. District Court for the District of Minnesota, alleges this practice violates law that requires a health plan’s money to be used for benefits only for that specific plan. The lawsuit claims that UnitedHealth used cross-plan offsetting to take money from employee contributions for self-insured plans to resolve overpayments by the insurer’s subsidiary under fully insured plans.

In an emailed statement to Becker’s Hospital Review, UnitedHealth said it “is committed to improving affordability, and overpayment recovery is an important tool in these efforts. We will continue to enhance this process for our customers, who support our efforts to recover these funds on their behalf. We will vigorously defend ourselves in this matter.”

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