United Healthcare (n/k/a UnitedHealth Group) UCR Reimbursement Class Action Settlement

May 5, 2010

A Proposed Class Action Settlement Involving United Healthcare Corporation (Now Known As Unitedhealth Group), And Its Subsidiaries And Affiliates Will Provide Cash Payments To
Persons Who Received Or Furnished Out-Of-Network Healthcare Services And Who Qualify.

A class action settlement has been reached in a lawsuit pending against United HealthCare Corporation (now known as UnitedHealth Group), Ingenix, Inc., Metropolitan Life Insurance Company, American Airlines, Inc., and their subsidiaries and affiliates (“Defendants”) in the United States District Court for the Southern District of New York (styled American Medical Association, et al. v. United HealthCare Corporation, et al., Case No. 00 Civ. 2800 (LMM) (GWG)) alleging that Defendants provided insufficient UCR reimbursement for Covered Out-of-Network OON Services or Supplies, according to the United Healthcare | UnitedHealth Group UCR Reimbursement Class Action Settlement Notice.

The United Healthcare | UnitedHealth Group UCR Reimbursement class action complaint reportedly alleges that defendants used flawed Ingenix databases in determining reimbursement amounts for Covered OON health benefits, used OON reimbursement policies to reduce reimbursement amounts improperly for Covered OON health benefits and inadequately disclosed the use of the Ingenix Databases and their OON reimbursement policies in determining reimbursement amounts for Covered OON health benefits, purportedly in violation of various state and federal statutes, including the Employment Retirement Income Security Act (“ERISA”), the Racketeer Influenced and Corrupt Organizations (“RICO”) Act, the Sherman Antitrust Act, as well as common law breach of contract.

The United Healthcare UCR reimbursement class action settlement, if it is finally approved by the Court, establishes a gross Cash Settlement Fund (various expenses, such as the costs of notice and claims administration and attorneys’ fees for Settlement Class Counsel, will be paid out of the Cash Settlement Fund) of $350,000,000 plus accrued interest to pay claims of eligible settlement class members who submit timely and valid claim forms.

You may be eligible for a settlement payment if you qualify and submit a valid Claim Form, if you were or are:

(1) a Subscriber, which means a member of a healthcare plan insured or administered by a Defendant, and received Covered Out-of-Network (“OON”) healthcare benefits at any time from March 15, 1994 through November 18, 2009 that were processed or reimbursed by a Defendant using the Ingenix Databases (the Prevailing Healthcare Charges System (“PHCS”) database or the MDR Payment System database) or one of the Seven OON Reimbursement Policies (Anesthesia Policy, Assistant Surgeon Policy, Co-Surgeon/Team Surgeon Policy, Multiple Procedure Policy, Preventative Medicine Policy, Professional/Technical Policy, and Reduced Services Policy); or

(2) a Provider or Provider Group, which means a healthcare Provider or healthcare Provider Group who furnished Covered OON Services or Supplies to a Subscriber at any time from March 15, 1994 through November 18, 2009 and whose claim for payment was processed or reimbursed by a Defendant using the Ingenix Databases or one of the Seven OON Reimbursement Policies.

Under the settlement, UnitedHealth Group and its affiliates have also agreed that they will, among other things, stop using the Ingenix Databases at issue in the class action lawsuit and will contribute $50,000,000 towards the funding and implementation of a new database.

United HealthCare Corporation or UnitedHealth Group subsidiaries and affiliates include, among others, the following:

  • Oxford Health Plans, Inc.
  • MAMSI
  • Sierra Health Services, Inc.
  • Fidelity Insurance Group
  • PacifiCare Health Systems, Inc.
  • Touchpoint Health Plan, Inc.
  • Mid-Atlantic Medical Services, Inc.
  • Neighborhood Health Partnership, Inc.
  • Golden Rule Insurance Company
  • Definity Health Corp.
  • HealthWise
  • John Deere Health Care, Inc.
  • HealthPartners of Arizona, Inc.
  • IBA Health & Life Assurance Co. and  IBA Self-Funded Group, Inc.
  • PHP, Inc.
  • MetraHealth
  • Arnett Health Plans, Inc.
  • GenCare Health Systems, Inc.
  • HCT
  • Student Resources (former student insurance United Medical Resources, Inc. division of MEGA Life and Health Insurance Co.)
  • (UMR) Fiserv, Inc.

The Honorable Lawrence M. McKenna of the United States District Court for the Southern District of New York (the “Court”) has scheduled a hearing to consider the fairness, reasonableness, and adequacy of the Settlement, to be held on September 13, 2010 at 10:30 a.m. at the United States Courthouse, United States District for the Southern District of NewYork, 500 Pearl Street, NewYork, NY (the “Final Settlement Hearing”).

For more information on the United Healthcare UnitedHealth Group UCR reimbursement class action litigation settlement and potential settlement benefits, call the United Healthcare class action claims administrator at 800-443-1073, send an email to unitedhealthcare@berdonclaimsllc.com or visit the United Healthcare UCR class action settlement website:

www.unitedUCRsettlement.com

If You Have Thoughts On The United Healthcare UCR Reimbursement Class Action Lawsuit Settlement, Share Your Settlement Comments Below.

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    { 179 comments… read them below or add one }

    Tom February 3, 2012 at 4:33 pm

    Everyone should call Berdon Claims. I call and they did not have my name on file. They check first my ss# not there, my name not there,than they check my address and there I was. They typed my ss# incorrectly. Now I have a claim number that I can refer to. Make sure they have the correct info on file about you. This may hold up our payments too.

    Reply

    Tom February 3, 2012 at 4:42 pm

    To EVERYONE:
    This is an important message. Please read this. I called Berdon last week regarding my claim. They told me that they never recieved it. I sent it register mail/receipt requested. They did receive it. I was told to resubmit all my paperwork back to them. I hung up and thought for a minute or two and called back. I asked the gentleman to recheck my info. First my ss# no luck, my name no luck, than he asked me for my address and behold here I am. What happen was that they typed my ss# wrong so they had incorrect info on me. Now I have a claim number and waiting for my check. I was told at that time that checks will be cut sometime during the 1st quarter of 2012.
    I recommand to call Berdon Claims if you do not have a claim number to recheck the info they have on file. I do not know if this will also delay our checks from being sent out.

    Reply

    susan February 5, 2012 at 8:45 am

    what is the correct number to call.. they refer everything to website, then back to mail. please help.i am also waiting for reinbursement .

    Reply

    K Dawg February 4, 2012 at 9:22 am

    Just checked Berdon Website Site This is what is posted;

    Distribution Order Received

    Checks will begin to be mailed shortly

    Reply

    Darl February 6, 2012 at 8:38 pm

    Will Group A receive and settlement funds?

    Reply

    Carol February 9, 2012 at 8:07 pm

    Every time I call 800-443-1073 and the recording tells me to press the prompt to speak to a customer service rep, the phone hangs up. Does this happen to anybody else ? And does anybody else have another number that i can call ? I’m waiting on a check as well.

    Reply

    BDEGRAF February 10, 2012 at 1:47 pm

    I emailed them my claim number and asked if they could tell me an estimated payout or when.

    My reply was “we expect all checks to be mailed by March 31st”

    that was all I got out of them they won’t tell you anything else.

    If anyone receives a check please let us know.

    Good luck!

    Reply

    monte February 10, 2012 at 6:02 pm

    what a sad situation. the attorney fees have to be astronomical. our checks, if sent out, will be a disappointment i fear. may have better luck winning the lottery. what a sad system.

    Reply

    Charmaine Osowicki February 13, 2012 at 10:21 am

    when speaking to a gentleman at BC,he states the judge has signed everything needed and checks will be mailed March31,2012. I hope he has his facts right. April fools?.

    Reply

    MFSGEO February 13, 2012 at 4:27 pm

    Latest today is the checks will be mailed in March. Person on the phone does not know when or the amounts. The recording at Berdon says the payments will be less than the amount claimed, which should not be a surprise, due to the volume of claims The person on the phone is not able to say what percentage of the claim amounts will be paid.

    Reply

    K Dawg February 13, 2012 at 6:09 pm

    Priceless

    Reply

    Darl February 13, 2012 at 6:13 pm

    So if the amount paid will be less than the amount claimed then those that applied as group A will most likely receive Zip, Zero, Zilch!!

    Reply

    Marsha February 13, 2012 at 7:15 pm

    Our practice was underpaid 1.9 million over 15 years. Would like to know what we should be getting. Provided 15 years of paperwork substantiating payments. No one will tell anything

    Reply

    K Dawg February 13, 2012 at 8:21 pm

    maybe I will get enough money to go to the movies by myself, no pop corn or soda either…. I am sure somebody is getting money out of this, but it won’t be us!

    Reply

    MFSGEO February 14, 2012 at 9:21 am

    The Class A settlement amount is $50 million. Do not know the amount of claims that go against the $50 million but there will be some payment.

    Reply

    Charmaine Osowicki February 14, 2012 at 9:41 pm

    $50 million…is that before or after the lawyers take their payments, mailing fees and whatever.

    Reply

    Frank February 20, 2012 at 11:29 pm

    According to amednews.com,recipients will receive $25,000! However if you do the math,it only comes out to $333.00! who knows?

    Reply

    MFSGEO February 21, 2012 at 10:27 am

    Frank and all. It is a little different. The 25K will go to the individual named physicians and patients.

    The amount for all us others is not mentioned. Here is the section from amednews:

    Now that the litigation has been wrapped up, the $350 million — plus interest, and minus attorneys’ fees and the cost of sending the settlement notices and checks — is on its way to doctors and patients. Checks were expected to be in the mail beginning in February.

    Attorneys will receive $87.5 million in fees and $1.5 million reimbursement for costs. The named individual plaintiff physicians and patients each will get $25,000. Berdon Claims Administration, the agency that is processing claims and mailing checks, will get about $13.8 million. An additional $8.1 million went toward the cost of the initial settlement notices. Physicians will receive about $200 million in all. Patients will get about $50 million.

    Reply

    vickie starks February 21, 2012 at 3:49 pm

    Out of all of that money, the patients the people dealing with the illness, pain and hurt are only getting 50million, but the attorneys and doctors are getting the money. Thats sad, cause if it wasn’t for the patients and them paying their insurance there would be no lawsuit!!

    Reply

    monte February 21, 2012 at 4:48 pm

    business doesn’t care about individuals. if the business did the correct thing there would be no need for the lawsuit. but that is in a fantasy land.

    Reply

    Darl February 21, 2012 at 6:35 pm

    Will the 50,000,000. be distributed among all the groups? A, B, C, D? I’ve read that UHC has 60,000,000. members. I am so confused.

    Reply

    SANDY February 22, 2012 at 10:57 am

    DON’T EXPECT MUCH. CALLED TO THE NUMBER TODAY. THE UPDATED INFO AFTER YOU PRESS #1 SAYS: ALL THE CHECK AMOUNTS HAVE BEEN REDUCED…………..SO MUCH FOR PEOPLE EXPECTING GOOD NEWS. WHAT A WORLD!!!!! BIG WINNERS? NOT US.

    Reply

    Dean February 23, 2012 at 9:16 am

    Agent with Berdon Claims verified my claim today. He says the approximate amount of the check should be for $11 per year of coverage.

    Definitely less than I was expecting, but better than some other class-action checks worth less than it cost to mail. I hope the doctors get some money out of this, because it doesn’t look like much coming to us patients.

    Reply

    MFSGEO February 23, 2012 at 10:26 am

    Good info on the $11 per year, which is 22% of the amount claimed for the Class A claimants.

    Class B, C could be a higher or lower percentage based on $200MM to be paid to those classes but with an unknown amount of approved claims.

    Reply

    Janie February 23, 2012 at 11:19 am

    I find it interesting, that since my husband and i made claims for the out of network united health care litigation, our deductible has gone up from $350.00 per person per year to $1000.00 per person per year…coincidence? I think not!!

    Reply

    vickie February 23, 2012 at 11:39 am

    I just spoke someone today from berdon,he stated that of the claimants will not be get a lot of money at all,rich keep getting richer and the poor keep getting poorer! WHAT SHAME BEFORE GOD!

    Reply

    diane February 24, 2012 at 12:22 pm

    just called berdon, representative says my amount should be $68.00…what a JOKE! check your address…1-877-536-6798……….I wonder what the LAWYERS are getting.

    Reply

    Shannon O February 24, 2012 at 4:02 pm

    I got my check today. It was like 2% of what I submitted. Plan to be disappointed.

    Reply

    Me Here February 24, 2012 at 8:03 pm

    Got ~3%.
    A joke.

    Reply

    Charm February 26, 2012 at 10:48 am

    how many of those millions are taxable for them? I am laughing all the way to the bank, I hope they can cover it.

    Reply

    Gary Shapiro February 27, 2012 at 11:53 am

    I spent weeks gathering all the documentation required. I had about $1,100.00 coming. Thanks to the greedy lawyers all I’m getting is about $160.00. The scumbag lawyers should get $0.1391 on their fee dollars. Here’s the lowdown on why we are getting next to nothing straight from the horses mouth (or maybe ass’s mouth).

    Garry Rothbaum, J.D.
    Director of Claims Operations
    Berdon Claims Administration LLC
    516-414-3321 Direct
    516-222-0271 Fax
    grothbaum@berdonclaimsllc.com

    After a reduction of 20%, but no more than $2,000.00, payout is calculated at $0.1391/dollar. All claims are subject to a pro rata distribution. As stated in the Notice on pages 4-5 (see attached), settlement proceeds will be reduced if the amount of claims filed exceeds the settlement fund. We received in excess of $1.5 billion in claims and as such, all settlement proceeds were reduced in accordance of the Plan of Allocation.

    Group A claims will be paid at about $11.50 for each year of coverage.

    Group A checks will be mailed by March 31, 2012.

    Reply

    K Dawg February 28, 2012 at 6:23 pm

    Sad so Sad, the lawyers are sending this country down the tubes. I am sure all of time they spent in court ( probably about 4 hours a day)and laboring by the copy machine (min wage staffers or interns) is worth millions….NOT

    Reply

    Venetia Waller March 4, 2012 at 2:07 pm

    I’m going to wait on God. “Keep the Faith.”

    Reply

    Matreia Gentry April 3, 2012 at 6:38 pm

    AMEN!!!!!!!!!! It is about time someone gave GOD the Glory! I am leaning on Him!

    Reply

    Dr. Peck March 9, 2012 at 12:49 pm

    It amazes me that UHC continues to do the EXACT SAME THING they were sued for. Nothing has changed, they continue underpay claims. We have patients that have 80/20 plans and UHC is paying less than 50% when they are suppose to be paying 80%. Guess its time to slam them with another lawsuit.

    Reply

    Angel March 13, 2012 at 3:25 pm

    Doc,

    I wish it would help someone besides the attys to sue~ that’s all they want anymore is class actions……you can practically hear them SALIVATE in their tv ads on “bad” drugs”, etc …
    We are all at the mercy of the attys & Washington, so we’re all screwed because they have no conciense & all the money…

    Reply

    tiko March 16, 2012 at 7:30 am

    $128 and change for 10 years (the max) as class a participant. Anyone else get the same? More? Less?

    Reply

    Bob H March 16, 2012 at 6:15 pm

    Got my check today. $58. I chose the “take $50 per year” option, which should have netted me $250.

    I wonder, how much of the $350Million the lawyers took, and how much the disbursement company took?

    Reply

    Steven Kline March 26, 2012 at 11:42 am

    It looks like members who selected the $50 per year option, like you and me, only recovered about 23% of the amount we could be awarded. See my commenet below. This appears to be consistent with what others like yourself have posted about their recoveries.

    Reply

    shawn March 17, 2012 at 9:37 am

    I was sent a letter and told I would recieve 1500, guess what I recieved a check for 49.63 Thanks!!!!!!!!!!!!!!!!!!

    Reply

    Dave March 17, 2012 at 9:48 am

    I received my check Friday March 16th 2012. The amount is $105.49.

    To be honest I really have no clue what this is for. I receive 1 or 2 class action settlements a year and most are under $35.00. One Class Action Lawsuit about 5 years ago netted me $9 but my stock value dropped over $3,000 directly due to the lawsuit. These Class Action Lawyers are killing us little guys and salivating all the way to the bank.

    Dave

    Reply

    Darl March 17, 2012 at 2:06 pm

    I heard Class A went from $50. per year to $11. and change, but now you say there is a 10 year cap? Will they deduct for stamps too? Should never have gotten my hopes up. But that’s how it is for the average man.

    Reply

    Donald R March 20, 2012 at 8:46 am

    Received my check of $58.53 last friday. Some of the folks that I worked with and was covered by UHC did not receive a check thus far. Maybe they will by March 31st?

    Reply

    Charmaine March 21, 2012 at 8:53 am

    i hope uhc has a good lunch on our money. i paid 649.00 and 106. was my return, also a tax notice. i paid taxes on that money when earned it,now pay taxes on the same money again, whata funny joke..our government needs an enema…

    Reply

    MFSGEO March 21, 2012 at 2:17 pm

    OK – how about this one.

    I was/am a member of the Class for the entire period of the litigation under six different policy numbers/employers/direct pay. I filed separate claims for each of these policy numbers as I should have. I am now being told that my Group B payment at the low rate was it. They denied my Group A claims (without any notice of declination) even though they were for different periods than the Class B claim and and the amount of payment does not work out from the formula they have told us. When I have the time then a letter to Berdon (for whatever good that will do) with a cc to the Judge.

    Anyone have similar problems?

    Reply

    Darl March 21, 2012 at 8:43 pm

    Where is my pittance!!! It’s my money and I need it now!!!

    Reply

    Shane Kelly March 22, 2012 at 3:06 pm

    I received my check for $46 and change which covers the 4 years I had with UHC until 2010. Thank goodness I am no longer with them.

    Reply

    j. March 23, 2012 at 5:09 pm

    Received a check this week. $11 whole dollars. Unbelievable. The Berdon people have been rude and helpless throughout the whole process. I had simple questions that they wouldn’t answer.

    Reply

    Steven Kline March 26, 2012 at 11:22 am

    I received my check as a Class A member to the lawsuit last week. $50 per year for each of the seven years I had UHC resulted in a payment for $81.94 or less than 24% the recovery. Really? It is amazing that attorney’s fees and costs accounted for over 76% of the recovery. Seems like only the attorneys profited from this case.

    Reply

    J. March 26, 2012 at 1:49 pm

    I have not received any money or heard anything more about this ever since I was informed of being over-charged. The bills they submitted on file wasn’t even accurate. I paid WAY MORE than that and had alot of bills that never got submitted. I don’t know how these bills disappeared but they did even though I was charged for them and had to pay it. What a joke…

    Reply

    christopher york March 29, 2012 at 4:11 am

    I’m still waiting i’ve called them many times each time they would give me a differant aswer than the one before and last year they even said the checks were already in the mail that was in nov. of last yr. in 2011.

    Reply

    joan March 29, 2012 at 1:51 pm

    my brother-in law received his check , it was 72 dollars and some cents.

    Reply

    Darl April 2, 2012 at 1:18 pm

    Waiting for mine, no clue how much.

    Reply

    Eunice DeHaas April 2, 2012 at 4:01 pm

    $35.12 is a far cry from the $600. That was suppose to be given. Once again, the lawyers win!!!!

    Reply

    Larry April 3, 2012 at 7:54 am

    I got my check from United Healthcare yesterday for $167.87 thanks to an email I received from TopClassActions.com.

    Reply

    brenda April 3, 2012 at 2:36 pm

    I just got a check for $93.00, what crooks..

    Reply

    john pernula April 5, 2012 at 1:27 pm

    I just called the number and was told by a rude gentleman that my social security # and name and home address was not on file and unless the item was sent by certified that there is a good chance I am not on the list. This sounds like something the big guys get fatter from the little guys.

    Reply

    Charms April 12, 2012 at 12:04 pm

    I see uhc ads on tv i guess cheating regular consumers has been approved. where is karma.

    Reply

    Darl April 17, 2012 at 6:14 pm

    They said it was mailed 3/30/12, and nothing yet???

    Reply

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