Seventeen hospitals in Florida are suing UnitedHealthcare, alleging they were underpaid for emergency services delivered to thousands of out-of-network patients.
The facilities, all part of HCA Healthcare, claim the insurer reimbursed the care at rates that were too low, in violation of the law. According to a lawsuit filed in the Ninth Judicial Circuit Court of Florida, the underpayment totals approximately $145 million.
According to the plaintiffs, since 2022, more than 5,500 patients—all covered by UnitedHealthcare—have been treated at HCA facilities for emergency medical needs. Despite the fact that the hospitals do not accept the medical plans of these patients, the facilities are required by federal and state laws to provide care.
The hospitals argue that, typically, such services would be reimbursed at market rates for the area. However, they say the insurer has paid less for the out-of-network patients than is customary for emergency room visits.
“Under Florida law, United is solely responsible for payment to the hospitals for emergency services and care provided, and United ensures that the member is not liable for any additional amounts that the member would have owed had the member obtained services from a participating provider,” the court filing reads.
HCA said they have not agreed to any discounted reimbursement amounts for the patient cohort in question and expect to be paid the full amount owed to an in-network facility.
The 17 plaintiffs include:
- Osceola Regional Hospital
- Central Florida Regional Hospital
- Poinciana Medical Center
- Oviedo Medical Center
- UCF Lake Nona Hospital
- Marion Community Hospital
- Putnam Community Medical Center
- North Florida Regional Medical Center
- Lake City Hospital
- West Florida Regional Medical Center
- Fort Walton Beach Medical Center
- Tallahassee Medical Center
- Twin Cities Hospital
- Gulf Coast Hospital
- Lawnwood Medical Center
- Raulerson Hospital
- St. Lucie Hospital
Attorneys representing HCA are demanding a jury trial to resolve the dispute. HealthExec