National medical group in pursuit of fair reimbursement for clinicians providing life-saving emergency care to patients across the country
NASHVILLE, Tenn. — Envision Healthcare (“Envision”), a leading national medical group, was awarded $91,270,257.00 by an independent arbitration panel on March 30, 2023, in its arbitration against UnitedHealthcare for underpayment of essential medical care. In addition to the award, the panel will separately assess prejudgment interest and decide Envision’s entitlement to attorney’s fees, costs, and expenses as a prevailing party.
“While we are very pleased with the outcome,” said Jim Rechtin, CEO of Envision Healthcare, “it should not take five years to get paid for the lifesaving care our clinicians provide. We currently have three other lawsuits against UnitedHealthcare, which will likely take several more years to resolve. It is challenging to create a stable environment for our teams when health plans choose not to pay their bills.”
The decision to award Envision $91,270,257.00 was made by an independent three-member panel of American Arbitration Association arbitrators. The award concerns care that Envision provided to UnitedHealthcare members in 2017 and 2018. At the time, Envision and UnitedHealthcare had an in-network agreement, but UnitedHealthcare unilaterally reduced reimbursement to Envision clinicians in violation of the network agreement. The award compensates Envision for UnitedHealthcare’s breach of contract.
“This decision sets a critical precedent for insurers like UnitedHealthcare to pay in full for the high-quality care its members receive in their most acute time of need,” added Rechtin. “While we are disappointed that we had to take the step of entering into arbitration to compel UnitedHealthcare to pay its bills, we are satisfied with the panel’s decision against UnitedHealthcare and its systematic underpayment to clinicians for the care they provide.”
About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a leader in ambulatory surgical care, AMSURG holds ownership in more than 250 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.