Maryland's insurance commissioner ordered a UnitedHealthcare subsidiary to pay millions of dollars to Maryland physicians after three IPAs with which United contracted defaulted on the payments.
It's unclear when or if doctors will collect, however, as United officials plan to appeal the order to the courts.
Commissioner Steven Larsen upheld on April 27 a departmental order issued in December requiring UnitedHealthcare of the Mid-Atlantic--whose Minneapolis-based parent company, UnitedHealthcare, is the nation's second-largest insurer--to pay an undetermined amount of money to physicians. One IPA owed physicians more than $2.9 million. It was unknown how much the other two IPAs owed.
The December order required United to reimburse physicians for any unpaid bills incurred as a result of treating United patients. The bills went unpaid after the three IPAs went out of business and failed to pay an undetermined number of physicians.
United officials appealed the decision, and the commissioner's office held a hearing in April. The hearing officer upheld the order.
The order requires United to pay by June 1 with accrued interest.
"The ruling was disappointing but not unexpected," United spokesman Roger Cruzan says. "We do believe the commissioner is being overly broad in interpreting the statute."
United officials empathize with the providers who weren't paid, he says, but making United pay twice isn't the answer. He adds United is "confident" it will get the result it wants.
"We paid a flat monthly amount, and (the IPA) is supposed to pay physicians . . . We think it's unfair to expect us, when we originally asked (the IPA) to pay them, to have to pay (the doctors) again while the IPAs can just stand behind the legal protection of bankruptcy," Cruzan says.