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Court Approves Award Payments in AMA Legal Battle Against UnitedHealth

For immediate release:
Feb. 9, 2012

ChicagoA federal court judge has cleared the way for releasing payments in the 2009 settlement that ended the historic court challenge led by the American Medical Association against UnitedHealth Group. Nearly $200 million in awards will be paid to settle claims from physicians for 15 years of artificially low payments from UnitedHealth for out-of-network health services.

“The truly lasting legacy of this court challenge will continue long after the last physician has received a share of the landmark settlement,” said AMA President Peter W. Carmel, M.D. “UnitedHealth and other insurers will no longer will be able to pull the wool over doctors’ and patients’ eyes when determining payment rates for out-of-network care.”

During a decade-long fight spearheaded by the Litigation Center of the AMA and State Medical Societies, the AMA worked diligently with organized medicine, state regulators and U.S. senators to expose a fundamental conflict of interest at UnitedHealth, which called into question the entire insurer-controlled system for paying out-of-network medical bills.

AMA brought evidence of UnitedHealth’s improper business practices to the attention of former New York Attorney General Andrew Cuomo in 2008, who confirmed the abuses with his own investigation. Under legal pressure from Attorney General Cuomo, UnitedHealth and several major insurers agreed in 2009 to meaningful reforms and to fund a new, independent system that can be used to accurately set usual, customary and reasonable rates.

“The new FAIR Health database takes the insurer sleight of hand out of the process and publicly reports the fair rate for any given out-of-network services,” said Dr. Carmel. “Patients and physicians will be able to go online to see how much a particular service is likely to cost - and how much the insurer is willing to pay - before the patient even sets foot inside the doctor's office.”

“The AMA’s stand against UnitedHealth shows that when doctors join together and enlist the help of organized medicine, the best outcome for patients and doctors can be achieved,” said Dr. Carmel. For more information on the organized medicine’s continued efforts to reform the improper business practices of insurers, please visit the AMA Litigation Center.

Physicians can turn to the AMA’s newly updated Practice Management Center for additional information on the timing of settlement distribution and related resources.  



Robert J. Mills
American Medical Association
(312) 464-5970

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