Fighting for Physicians: CSMS Announces UnitedHealth Settlement

CONNECTICUT STATE MEDICAL SOCIETY ANNOUNCES SETTLEMENT OF LITIGATION AGAINST UNITED HEALTHCARE

(North Haven, CT) – In a settlement announced today by the Connecticut State Medical Society (CSMS), UnitedHealthcare Group has agreed to spend $11.5 million to resolve actions brought by four medical societies and individual physicians challenging United’s provider claims payment practices. Under the settlement, which resolves actions pending for over a decade, United will spend a minimum of $9 million in extensive enhancements to United’s provider self service website, with the objective of increasing efficiencies and reducing delays in the areas of claims management and claims resolution. The settlement also provides for additional monies to be paid by United and allocated to Connecticut State Medical Society Physicians Health and Education Fund (CSMS PHEF) for educational programs for Connecticut State Medical Society members, including programs focused on topics such as Current Procedural Terminology coding, ICD-10-CM coding, medical review audits and appeals, and electronic claims submission and processing, as well as the creation of a Physician Advisory Council in the State of Connecticut.

Read coverage of the settlement: Courant

Karen Laugel, MD filed the action back in 2001 as lead physician plaintiff from Connecticut. Dr. Laugel, a board-certified pediatrician specializing in pediatric head trauma, has pledged all funds that she has received to the Foundation for Children of the Connecticut chapter of the American Academy of Pediatrics. “I am so pleased that this case has been resolved after years of litigation,” said Laugel. “I applaud the Connecticut State Medical Society for their perseverance in this case over the years. The outcome will benefit patients and physicians in the State of Connecticut.”

Connecticut State Medical Society President Robert Russo, MD stated, “This settlement is a victory for physicians and patients in Connecticut. I want to thank Dr. Laugel for her dedication to this case. The settlement of this long litigation is another example of our continued advocacy on behalf of the physicians of Connecticut and their patients.”

Connecticut State Medical Society Executive Vice President, Chief Executive Officer, Matthew Katz, MS, further indicated, “The changes United is making to their online management and resolution processes will benefit both physicians and patients. The funding will allow the CSMS PHEF to provide continued high quality, relevant education to the physicians of Connecticut.”

“The settlement marks the conclusion of over a decade of hard-fought litigation, providing significant relief in the areas of claims management and claims resolution,” said Edith Kallas, counsel for plaintiffs and a partner at Whatley Kallas, LLP. “We applaud the medical societies and individual physicians for their commitment to obtaining a meaningful resolution of these issues.”

Click here to view the press release as a PDF.

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