UnitedHealthcare sues hospital staffing firm TeamHealth, alleging $100M in fraudulent claims

Matt O'Connor | | Health Exec | Policy & Regulations
UnitedHealthcare UHC UnitedHealth

Commercial health insurance giant UnitedHealthcare has filed a lawsuit alleging TeamHealth billed for pricier hospital staffing services than physicians actually provided.

UHC is arguing TeamHealth, a company that staffs hospital emergency rooms, purposely upcoded claims, according to the lawsuit filed Oct. 27. The insurer estimates it’s overpaid by some $100 million since 2016 due to the firm’s alleged fraudulent practices.

In fact, UnitedHealthcare analyzed emergency department records and says 62% of TeamHealth’s claims involving the highest-paying ED codes did not match medical records, Axios first reported Wednesday, Oct. 27.

Leif Murphy, CEO of Knoxville, Tennessee-based TeamHealth, downplayed the lawsuit in a statement sent to Axios.

“Courts have repeatedly dismissed these claims in other jurisdictions,” Murphy said. “United continues to generate record profits by down coding claims and refusing to consider the expertise of frontline clinicians who make a diagnosis,” he added.

In the statement, Murphy also claimed UnitedHealthcare is seeking to divert attention from a lawsuit brought by TeamHealth affiliate Fremont Emergency Medicine against the insurer for significantly underpaying clinicians.

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Matt O'Connor

Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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