1. In the ongoing legal battle between UnitedHealthcare and TeamHealth, John Haben, a former UnitedHealthcare executive, testified that the company would only pay for surprise medical bills if members complained to the insurer. He also testified that UnitedHealthcare paid providers as little as 20 percent of billed charges. Litigation is ongoing.
2. A whistleblower lawsuit is alleging that Aetna used dead, out-of-state or nonpediatric physicians to bolster its Pennsylvania Medicaid network. The lawsuit claims that “tens of thousands” of children were assigned providers not connected with Aetna.
3. A class-action lawsuit is targeting United Behavioral Health over denied mental healthcare claims. The lawsuit claims that the “bundled” payments were restrictive to patient coverage.
4. An antitrust lawsuit is alleging that MultiPlan and a handful of national payers denied providers over $90 billion in payments since 2012. The alleged “hub, spoke and rim” agreement artificially reduced out-of-network payments, the plaintiff claims.
5. UnitedHealthcare is suing TeamHealth over emergency room bills that it claims were upcoded to cost the payer over $100 million.
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