Envision’s lawsuit against UnitedHealthcare dismissed
A federal court in Florida has dismissed Envision Healthcare’s lawsuit against UnitedHealthcare, saying the two sides will have to settle their contract dispute through arbitration.
Envision had sued the insurer in March, alleging UnitedHealthcare “unilaterally” negotiated payment rates and failed to add Envision physicians to its network after the acquisition of AmSurg in 2016. UnitedHealthcare argued Envision’s emergency room billing practices were “egregious,” but also said the lawsuit itself was a violation of the arbitration provision in their contract.
A U.S. District Court judge sided with UnitedHealthcare, saying any move to change payment rates doesn’t waive that provision and, therefore, Envision can’t take this dispute to the courts.
“To extend the waiver rule to a contractual breach alone would…render arbitration provisions meaningless,” the court’s decision read.
UnitedHealthcare had already moved to sever ties with Envision before the decision. Parent company UnitedHealth Group dropped its bid to buy Envision’s ambulatory services unit after the lawsuit was filed. After setting up a website criticizing Envision’s billing practices for emergency room care, it said in an April 6 court filing its contract with Envision would be terminated no later than Jan. 1, 2019 because Envision had been “unwilling to address matters … in a reasonable and satisfactory manner—demonstrated most recently by the filing of this lawsuit in blatant disregard of the parties' valid and enforceable arbitration provision.”
HealthExec’s requests for comment on the court decision weren’t immediately returned by either Envision or UnitedHealthcare.
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.