Court rules in favor of class standing in UHC/Optum lawsuit
Written by Editor   
Thursday, September 18, 2014 04:53 PM

A long-awaited decision was issued by the U.S. District Court in the pending action against United Healthcare/OptumHealth, a case led by the American Chiropractic Association: The Court granted class standing, which not only allows plaintiffs who are not within United’s network of providers to seek relief on a class-wide basis, but also endorses the applicability of the Employee Retirement Income Security Act of 1974 regulations to UHC/Optum’s requests for repayment.

The decision is a landmark step toward the goal of achieving significant reform of UHC/Optum practices. Any out-of-network DCs who are currently subject to a repayment demand from United or Optum should contact the ACA concerning the impact of the decision.

The lawsuit was first filed in 2011, by the ACA, who represented a nationwide class of healthcare providers who were subjected to improper audits and recoupment demands by UHC in a violation of ERISA. On April 22, 2011, ACA amended the original complaint alleging that United, through its chiropractic network, OptumHealth, adopted a series of internal policies and procedures intended to improperly deny benefits.