U.S. Anesthesia Partners of Texas, P.A. v. United Healthcare InsuranceDate Filed: March 31, 2021
District Court: 14th District Court, Dallas County – No. DC-21-04104
Nature of Suit: Antitrust - Anticompetitive Conduct
Defendant Type: Provider
Plaintiff Type: Private
Case Info: https://sourceonhealthcare.org/united-health-care-accused-of-using-market-power-for-financial-gain-impeding-provider-competition-in-texas-and-colorado/#_ftnref3
Court Document: https://www.bloomberglaw.com/product/blaw/document/X7BOLE3EMI69TBBTT0PB1D4V8VU, https://www.bloomberglaw.com/product/blaw/document/X5CN9IMK4179HA8NEST2BFVOR6E
In late March, a group of doctors sued United Healthcare Insurance in Texas state court, alleging the insurance giant violated state antitrust laws. Plaintiffs U.S. Anesthesia Partners (USAP) is a physician practice group made of anesthesiologists who practice in nine states. In the complaint, they claimed that United Healthcare used its market power to “squeeze” the group out of its insurance network and the marketplace for its own financial gains. Specifically, USAP alleged that United Healthcare bribed and used financial penalties to force in-network providers to refer patients to other anesthesiologists and avoid USAP.
The Texas lawsuit, filed in Dallas County, alleges United Healthcare engaged in unreasonable and unlawful restraint of trade in violation of the Texas Free Enterprise and Antitrust Act of 1983. The complaint claims that United Healthcare used an unlawful scheme to force USAP Texas out of its insurance network that includes:
- bribing in-network surgeons with 50% more compensation to steer patients away from USAP;
- imposing penalties on healthcare facilities to force them to stop using USAP; and
- coordinating and conspiring with USAP’s competitors, many of them physician groups that are affiliated with United via Optum, to pressure surgeons to refer cases toward specific anesthesia providers and away from USAP to drive it out of market.
On August 5, 2021, the court granted United’s motion to compel USAP to arbitrate the claims pursuant to the arbitration provisions in their agreement. Subsequently, the case was dismissed.
Similarly, the USAP also filed a lawsuit in late March in Denver County of Colorado claiming United Health engaged in an unlawful scheme to eliminate USAP Colorado from its network, in violation the Colorado Antitrust Act of 1992. The lawsuit specifically alleges United engaged in unlawful conduct constituting, among other actions, unreasonable and unlawful restraint of trade.