From the HCMS Physician Newsletter, July 2010 issue
UnitedHealth Group UCR settlement with the AMA
The American Medical Association (AMA) reached a settlement against UnitedHealth Group (UHG), the nation’s largest health insurer, for more than $350 million which is available to compensate physicians and their patients for 15 years (March 15, 1994 through November 18, 2009) of artificially low payments for out of network (OON) services. If you have been in-network with UnitedHealth Group plans during this time period, this settlement is not for you.
The UHG settlement is governed by a series of court-imposed deadlines that physicians must follow. The current settlement deadlines include the following key dates:
July 27, 2010 – Deadline for filing objections to the settlement or for opting-out of the settlement.
September 13, 2010 – Date for the final settlement hearing to consider any filed objections.
October 5, 2010 – Deadline for filing a claim to share in the settlement fund.
On April 16, 2010, the Settlement Claims Administrator began mailing the Settlement Notice, claim form and claim form instructions for the UHG UCR settlement to physicians. Physicians will be receiving a plain white mailer with “United Healthcare” written on the bottom and with the return address referencing the Settlement Claims Administrator: United HealthCare Class Action Litigation c/o Berdon Claims Administration LLC, P.O. Box 15000, Jericho, NY 11853-1001. The mailer includes the Settlement Notice, claim form and claim form instructions. Please do not throw away this information. Though the settlement document looks intimidating, the AMA offers tools to help you streamline the process.
Physicians can receive a settlement(s) as a provider of care and as a subscriber to UHG as a member of any of its plans.
a. Provider or Provider Group – furnished covered OON services or supplies to a Subscriber (patient) at any time between March 15, 1994 through November 18, 2009.
b. Subscriber – a member (patient) of a healthcare plan insured or administered by UnitedHealth Group, and received covered OON healthcare benefits at any time from March 15, 1994 through November 18, 2009.
Provider or Provider Group
As a provider of care to receive a settlement payment you must complete a claim form that was delivered to you through the USPS, or you can go online to http://berdonclaims.com/case_files/261_527file.pdf to download a copy. Go to http://www.ama-assn.org/ama1/pub/upload/mm/368/uhg-step-by-step.pdf and follow the step-by-step guide to maximize your recovery. This guide will even help you get your OON history from the settlement claims administrator at Step #3.
As a subscriber you also must complete a claim form. There are several levels to apply for a settlement payment. The easiest is just informing the settlement claims administrator of how many years you were a subscriber and get $50 for each year. This information is also good for your staff. If, as a business owner, you offered health benefits from UnitedHealthcare between the qualified dates, your staff can file as a subscriber too.
For more comprehensive information about the UHG settlement and the list of plans associated with the settlement, please see http://www.ama-assn.org/go/settlements. And for helpful resources specific to the UCR settlement, please see http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy/private-sector-advocacy/health-insurer-settlements/unitedhealth-ucr-settlement.shtml.
From the HCMS Physician Newsletter, May 15, 2010 issue
The American Medical Association’s (AMA) 2010 legal victory over UnitedHealth Group makes available more than $350 million to compensate physicians for 15 years of artificially low payments for out-of-network services.
Evidence of UnitedHealth’s improper business practices was brought to the attention of New York Attorney General Andrew Cuomo, who confirmed the abuses with his own investigation. Under legal pressure from Attorney General Cuomo, UnitedHealth and several other major insurers agreed to meaningful reforms that promise to help keep the system for determining out-of-network reimbursements free from further corporate manipulation.
The UnitedHealth settlement is governed by a series of court-imposed deadlines that physicians must follow. The current settlement deadlines include the following key dates:
July 27, 2010 – Deadline for filing objections to the settlement or for opting out of the settlement.
Sept. 13, 2010 – Date for the final settlement hearing to consider any filed objections.
Oct. 5, 2010 – Deadline for filing a claim to share in the settlement fund.
To learn more about the settlement and download a claim form, please click here (AMA Web site).