Testimony continued this week in the high-stakes trial in which TeamHealth-affiliated Nevada emergency room clinicians seek millions in alleged underpayments from healthcare giant United. TeamHealth alleges that United, while reaping billions of dollars in profits from its Shared Savings Program, exposed its members to potentially millions of dollars in surprise medical bills. The former head of United’s Shared Savings Program, John Haben, returned to the stand yesterday for his fifth day and testified that United paid as little as 20% of the clinicians’ billed charges under a program which TeamHealth lawyer John Zavitsanos described as having “no member protection.”
Haben indicated, however, that United would pay surprise balance bills if a member complained about them. Zavitsanos asked Haben whether United had ever publicized that protection to members when it moved those members into the Shared Savings Program that exposed them to balance bills. Haben responded that members “get an EOB [explanation of benefits] that says they can call if they have questions on the reimbursement.” Zavitsanos pressed Haben, “Sir, I’m not talking about the fine print that says, call the office if you have a question. My question is, when you cut these rights the way you did, did you notify the membership that if you get balance billed, United will pay for it?” Haben replied, “There’s a message on the EOB.” He later admitted, “No. There’s no letter that goes out.”
Court is closed today in honor of Veterans Day but will resume Friday. The trial is expected to continue into the week of Thanksgiving. TeamHealth’s more than 15,000 clinicians continue to watch the trial closely. At stake is the very ability of heroic frontline healthcare providers to get necessary reimbursements from large profitable insurers to cover the cost of the lifesaving care they provide.
At TeamHealth, our purpose is to perfect the practice of medicine, every day, in everything we do. We are proud to be the leading physician practice in the U.S., driven by our commitment to quality and safety and supported by our world-class operating team. To improve the experience of our physicians and advanced practice clinicians, we empower clinicians to act on what they believe is right, free clinicians from distractions so they can focus on patient care, invest in learning and development to promote growth in the clinical field and foster an environment where continuous improvement is a shared priority. Through our more than 15,000 affiliated healthcare professionals and advanced practice clinicians, TeamHealth offers emergency medicine, hospital medicine, critical care, anesthesiology, orthopedic surgery, general surgery, obstetrics, ambulatory care, post-acute care and medical call center solutions to approximately 2,900 acute and post-acute facilities and physician groups nationwide. Join our team; we value and empower clinicians. Partner with us; we deliver on our promises. Learn more at www.teamhealth.com.
The term “TeamHealth” as used throughout this release includes Team Health Holdings, Inc., its subsidiaries, affiliates, affiliated medical groups and providers, all of which are part of the TeamHealth organization. “Providers” are physicians, advanced practice clinicians and other healthcare providers who are employed by or contract with subsidiaries or affiliated entities of Team Health Holdings, Inc. All such providers exercise independent clinical judgment when providing patient care. Team Health Holdings, Inc., does not have any employees, does not contract with providers and does not practice medicine.
The collective term “United” as used throughout this release references defendants, UnitedHealthcare Insurance Company (“UHIC”), United HealthCare Services, Inc. (“UHS”), UMR, Inc. (“UMR”), Sierra Health and Life Insurance Co., Inc. (“SHL”), and Health Plan of Nevada, Inc. (“HPN”).
Case Name is Fremont Emergency Services (Mandavia), et al. vs. UnitedHealth Group, Inc et al. Case number is A-19-792978-B.