Thursday, August 19, 2010

United Healthcare Class Action Lawsuit

By now most physicians are aware of the class action lawsuit brought against UHC and its subsidiaries by the AMA and other plaintiffs.  The lawsuit alleges that UHC provided insufficient reimbursement for covered out of network (OON) services by:
  • using flawed databases developed by Ingenix in determining reimbursement amounts for covered OON health benefits;
  • using the OON reimbursement policies to reduce reimbursement amounts improperly for covered OON health benefits; and
  • inadequately disclosing the use of the Ingenix databases and their OON reimbursement policies in determining reimbursement amounts for covered OON health benefits.
The most important thing to understand about this lawsuit is that it applies only to non-contracted providers, as only they could have provided out of network (OON) services.  Since the vast majority of PDS clients are contracted providers with UHC, this class action settlement does not apply to you.  For more information on this and other payer-related class action lawsuits, click here.

Wednesday, August 18, 2010

McKesson EHR Webinar Highlights

McKesson hosted a comprehensive 1-hour webinar covering the final ruling on "meaningful use" and the funding available to physicians who implement a qualified EHR in their practice. Contact PDS or click here for a copy of the presentation.