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AMA Offers Physicians Help Claiming Damages From UnitedHealth Settlement

Thursday, April 22, 2010 General News
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More than $350 million available to physicians and patients
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CHICAGO, April 21 /PRNewswire-USNewswire/ -- The American Medical Association (AMA) today launched a new online resource that will help thousands of physicians file claims in the record-breaking settlement reached in the AMA legal victory against UnitedHealth Group -- the nation's largest health insurer. More than $350 million is available to help compensate physicians and their patients for 15 years of artificially low payments for out-of-network services.
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"The AMA is offering its support to physicians who are now receiving mailings containing details and claim forms regarding the historic UnitedHealth settlement," said AMA President J. James Rohack, M.D. "The new AMA guide provides physicians with step-by-step assistance in determining eligibility, assembling documentation and filing a claim under the terms of the settlement."

During the last decade, the AMA worked diligently with the Medical Society of the State of New York, the Missouri State Medical Association, the courts and regulators to expose and prohibit a price-fixing scheme used by UnitedHealth and other health insurers to underpay physicians and patients for out-of-network care.  

"The AMA's persistent efforts have earned significant results for physicians that extend far beyond the recovery of damages," said Dr. Rohack. "Every physician and patient will benefit from the stand the AMA took against UnitedHealth."

Evidence of UnitedHealth's improper business practices gathered in the course of the AMA-led litigation was brought to the attention of New York Attorney General Andrew Cuomo, who confirmed the abuses with his own investigation. Under legal pressure from Attorney General Cuomo, UnitedHealth and several major insurers agreed to meaningful reforms that promise to help keep the system for determining out-of-network reimbursements free from further corporate manipulation.

The UnitedHealth settlement is governed by a series of court-imposed deadlines that physicians must follow. The current settlement deadlines include the following key dates:

July 27 – Deadline for filing objections to the settlement or for opting out of the settlement.

September 13 – Date for the final settlement hearing to consider any filed objections.

October 5 – Deadline for filing a claim to share in the settlement fund.

In addition to the information available in the new settlement guide, the AMA offers members personal assistance from the AMA's Practice Management Center if they have questions about the settlement or filing a claim form. AMA members interested in retaining a claims submission service can obtain a discounted rate offered by the Managed Care Advisory Group.

"The AMA's continued fight in the name of fairness shows yet again that when doctors enlist the help of organized medicine, the best outcome for patients and doctors can be achieved," said Dr. Rohack.

For more information on the effectiveness of organized medicine's advocacy in the courts, including continued efforts to reform the improper business practices of insurers, please visit the Litigation Center of the AMA and State Medical Societies.

SOURCE American Medical Association

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