On behalf of out-of-network California ASCs, a Los Angeles law firm has filed a motion for preliminary approval to settle a class action complaint it filed more than six years ago.
The complaint alleges that United Healthcare Services and OptumInsight (together, United), formerly known as Ingenix, improperly calculated the reasonable and customary amounts for out-of-network ASCs, which resulted in underpayments of millions, according to the firm of Hooper, Lundy and Bookman (HLB). United has agreed to settle the case for $9.5 million.
The parties estimate that there are about 250 ASCs that could participate in the settlement. Assuming that the court preliminarily approves the settlement, notice of the settlement and instructions outlining how to participate in the settlement process will be sent to all potential class members, HLB said.
This case challenged the defendants’ calculations of reasonable and customary amounts under employer-provided healthcare benefit plans and health insurance policies that are governed by the Employee Retirement Income Security Act (ERISA). For more information about this case or the settlement, email [email protected].
