Judge tosses Envision lawsuit against UnitedHealth
A federal judge dismissed physician staffing firm Envision Healthcare's lawsuit against UnitedHealth Group in a case involving a payment dispute.
The U.S. District Court in Miami said late last week that the two companies must resolve their dispute through arbitration, as outlined in their contract.
The ruling is a win for UnitedHealth, which asked the court this month to force Envision to arbitrate the dispute. UnitedHealth has already opted to terminate its Envision contract no later than Jan. 1, 2019, according to a previous court filing.
Envision sued UnitedHealth on March 12, claiming the insurer violated a contract by refusing to add Envision doctors to its network and lowering payment rates in response to alleged overbilling. Envision also said UnitedHealth is trying to collect more than $140 million in overpayments to the staffing firm based on the newly lowered rates.
UnitedHealth Group shot back with a website describing how Envision's "outrageous billing practices" drive up costs for hospitals and patients.
In its initial complaint, Envision acknowledged that its UnitedHealth contract required the two companies to resolve any disagreements through arbitration rather than going to court. But Envision claimed that UnitedHealth waived that right when it lowered the payment rates despite Envision's objections.
U.S District Judge Ursula Ungaro disagreed, concluding that an alleged contract breach isn't enough to bypass the arbitration process.
"Envision Healthcare is appreciative for this decision that allows us to enforce our rights against United's unlawful practices," an Envision spokeswoman said in an email. "Whether in court or in arbitration, caregivers and patients need a voice against unfair insurance practices that leave patients without adequate insurance coverage. Envision is here to provide that voice."
A UnitedHealth spokesman did not immediately return a request for comment.
Nashville-based Envision, with annual revenue totaling $7.8 billion, is the nation's largest physician staffing firm with 25,000 physicians and other medical practitioners who staff hospital departments, including the emergency room, radiology, anesthesiology and neonatology. The company has come under fire for sending patients big out-of-network ED bills.
A July 2017 Yale University study found that hospitals outsourcing emergency department operations to Envision's EmCare unit saw increases in the rates of out-of-network doctor's bills, tests ordered and patients admitted to the ED. In September, Sen. Claire McCaskill (D-Mo.) wrote a letter to Envision CEO Christopher Holden requesting information on Envision's billing practices in light of the study.
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