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Health care giants set to face each other in court

Emergency rooms in Texas and around the country save thousands of lives each year, but providing this treatment can be costly. Many of the nation's ERs are staffed by nurses, doctors and specialists provided by Envision Healthcare, which has been accused by United Healthcare of using unscrupulous billing practices to overcharge both hospitals and patients. Envision responded to the allegation by filing a lawsuit against UnitedHealthcare on March 12. In the lawsuit, Envision concedes that its emergency treatment bills are high, but the company blames the costs on UnitedHealthcare.

According to the Envision lawsuit, ER costs are soaring because UnitedHealthcare will no longer accept new Envision providers. This means that patients treated by Envision ER doctors are frequently asked to pay out-of-network charges. According to Envision, UnitedHeathcare is refusing to admit new doctors into its program in order to improve its negotiating position and lower its costs.

UnitedHealthcare denies the claim and has created a new website that addresses the issues involved. On the website, UnitedHealthcare points out that Envision charges nearly 10 times more on average than Medicare for the same services. In a March 21 press release, Envision said that it was asking the courts to resolve the contract dispute because multiple attempts to settle the matter amicably have been unsuccessful.

Breach of contract litigation can be extremely complex and drag on for months or even years, and asking the courts to settle matters always involves at least some risk. Attorneys with experience in this area may urge parties involved in such a dispute to make every effort to reach a negotiated settlement, and they may suggest alternative venues, such as mediation or arbitration, when traditional negotiations fail to provide an agreement.

Source: Healthcare Finance News, "Envision sues UnitedHealthcare over contract dispute", Susan Morse, March 21, 2018

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