Anesthesiologists sue UnitedHealthcare, say insurer is pushing them out of market

A large anesthesiology group is suing UnitedHealthcare in two states, alleging the insurance giant is using its muscle to push providers to avoid referring patients to them.

In the lawsuits filed in Texas and Colorado state courts, U.S. Anesthesia Partners claims UnitedHealth used "multiple interrelated and unlawful tactics and pressure campaigns" to encourage providers to avoid USAP, including "bribing" in-network surgeons with contracts that included significant financial incentives to refer to other anesthesiologists.

In addition, UnitedHealthcare applied penalties on providers who contract with USAP to force them to use other anesthesiology partners, namely OptumCare providers, USAP says. UnitedHealth also aimed to poach docs from USAP, according to the lawsuit.

USAP says in the suit that UnitedHealth's central goal was to boost its own profits.

RELATED: Moody's: The industrywide implications of UnitedHealth's spat with TeamHealth

"United is like a boa constrictor squeezing USAP-TX from all sides. By acting in bad faith and disregarding its obligations owed to USAP-TX, United abused its position as the largest health insurance company to slash USAP-TX’s revenue and to divert business away from USAP-TX for its own benefit," the group said in the lawsuit.

However, UnitedHealth said in a statement to Fierce Healthcare that the lawsuit is a distraction from the fact that USAP was unwilling to negotiate its rates with the insurer.

USAP's rates are double the median rate paid to other anesthesiology groups in Texas and 70% higher than the median for similar groups in Colorado, UnitedHealthcare said.

UnitedHealthcare also said it had not yet been served with either lawsuit.

“USAP’s lawsuit is just the latest example of the group’s efforts to pressure us into agreeing to its rate demands and to distract from the real reason that it no longer participates in our network. The reality is that many private equity-backed physician staffing companies like USAP expect to be paid double or even triple the median rate we pay other physicians providing the same services," a UnitedHealthcare spokesperson said. "While these egregiously high rates help meet the profit expectations of their private equity owners, they also drive up the cost of care and make health care less affordable for people across the country.”

In the Texas suit, USAP is seeking $1 million in damages.

The nation's largest insurer has engaged in similar disputes with other large physician groups, including Envision and TeamHealth. Contentious contract negotiations with both companies in 2019 centered on surprise medical billing, for instance.

UnitedHealth cut Envision from its network as of Jan. 1.