By Dr. Scott Scherr, Regional Medical Director, Emergency Medicine
Since the onset of the COVID-19 pandemic two years ago, America’s frontline healthcare workers have stepped up time and time again, putting their lives on the line to help keep patients healthy and safe. While we may not know when or where the next tragedy will occur, one thing we can count on is knowing that our frontline physicians will be there to answer the call and care for the communities they serve.
Unfortunately, despite all of this, insurance giant UnitedHealthcare has prioritized profits over all else, by artificially and fraudulently reducing payments to thousands of clinicians through an illicit scheme, all at the expense of providers and patients.
Protect Healthcare Heroes
Compromising the quality of emergency medical care in a natural disaster, a mass casualty event, or in any community is a risk no one can afford. This is why, late last year, TeamHealth, a physician founded, physician-led, patient-focused integrated physician practice with more than 15,000 affiliated healthcare professionals, stood up to United by taking them to court to ensure that clinicians are reimbursed for the quality care they provide.
After hearing evidence for five weeks, a Las Vegas jury convincingly ruled in favor of three Nevada-based TeamHealth-affiliated medical practices, finding that United was guilty of “oppression, fraud, and malice” and engaged in “unfair and abusive reimbursement practices” by deliberately failing to pay the frontline emergency room doctors adequately for care provided to patients.
For far too long, emergency medicine physicians have been crippled by United’s unfair reimbursement practices. The court’s ruling has been a major victory for frontline healthcare workers who, for years, have played an integral and essential role in protecting the health and safety of the Las Vegas community.
Emergency medicine is unlike any other industry or profession. As healthcare workers, we have and always will put our patients first, regardless of their ability to pay. Whether treating heart attacks, gunshots, drownings, COVID-19, or other life-threatening ailments, our responsibility is to protect our patients and act fast, as such action is frequently the difference between life and death.
This was never more evident than in October of 2017, when a gunman opened fire on a crowd attending the Route 91 Harvest music festival on the Las Vegas Strip. This resulted in one of the deadliest mass shootings in the history of the United States, leaving 61 dead and 867 injured. As one of more than 100 medical first responders who reported to Sunrise Hospital and Medical Center in response to this horrific mass casualty, I am all too familiar with just how crucial it is that, as healthcare workers, we never stop acting in the best interests of our patients and continue to keep our communities safe.
In one example discussed in the trial, United reimbursed just $254 for emergency care on a gunshot wound sustained at the music festival. Our bill for this lifesaving medical treatment was $1400. A former United executive said that lifesaving care was “worth” the $1400 charge while testifying under oath – though United continues to refuse to pay any amount close to this. In fact, under United Healthcare’s “shared savings program” United made $401 for the care the emergency physician performed on this gunshot victim.
For billion-dollar insurance behemoths like United to capitalize on heartbreaking tragedies by raking in record-high profits is as unfathomable as it is cruel.
Nevada is just the Beginning
I applaud TeamHealth for its commitment to ensuring that our Healthcare Heroes can properly secure the necessary reimbursement from insurers to cover the costs of the lifesaving care they provide. The company continues to pursue similar legal action against United and other harmful actors in court cases in New Jersey, Pennsylvania, New York, Florida, Oklahoma, Arizona, Ohio and Texas. TeamHealth’s victory in Nevada was just the beginning and a step in the right direction towards holding bad actors everywhere, accountable.