Lawsuit filed against UnitedHealth for underpayment of telehealth services

Editor's Note

A female patient in Chicago, Illinois, filed a lawsuit on July 7 against the multinational UnitedHealth Group for alleged underpayment of telehealth services, Becker’s Payer Issues July 8 reports. The lawsuit claims that the woman’s insurance plan covers telehealth services, including pay benefits for-out-network services.

After receiving out-of-network psychotherapy prior to the pandemic, the patient transitioned to telehealth services with the same provider in July 2020. Most providers saw an unprecedent uptick in telehealth services during the COVID-19 pandemic, and some patients continue to rate telehealth visits favorably as a safe alternative to in-person visits.

When the Centers for Medicare & Medicaid Services (CMS) changed rates for telehealth service to match in-person services in April 2020—a measure that has been recently extended—UnitedHealth reportedly continued to provide coverage with the former, lower rates.

According to the lawsuit, the refusal to adhere to CMS policy allowed UnitedHealth to “take advantage of the increased use of telehealth services resulting from the COVID-19 pandemic to pay less in benefits for the same covered services, thereby enriching itself at the expense" of those it covers, Becker’s reported.