A 5-year class action lawsuit against TeamHealth finally concluded with a $15 million award potentially shared by some 3,000 emergency physicians in almost every state who submitted claims, minus court and other costs, according to a court-approved preliminary settlement.
The doctors, named in the as Forward Momentum, LLC, alleged in court filings that , one of the nation's largest medical staffing companies with 15,000 physicians, and its subsidiary Paragon Contracting Services, LLC, were in breach of their contracts and secretly cheated doctors out of a portion of the bonuses they were promised.
The physicians claimed that their contracts required TeamHealth to pay them a bonus when they supervised care provided by a physician assistant, nurse practitioner, or other advanced practice provider (APP).
"The importance of physician credit for assisting RVUs [relative value units] is easiest understood in the context of patient charts and the liability risk that physicians assume in signing those charts," the physicians' 2017 complaint explained. "A physician is responsible for every patient whose chart he/she signs, whether he/she sees the patient directly or simply supervises an APC's [advanced practice clinician's] treatment plan."
But, the complaint maintained, instead of paying the doctors for supervising APP care, "defendants were secretly subtracting out the assisting RVUs from the bonus credit on each paycheck, but failing to disclose this fact or provide Plaintiffs with sufficient data to figure out the truth."
"Because the underlying data was hidden from Plaintiffs, they could not determine that they were being cheated," the complaint alleged.
The complaint further claimed that TeamHealth added the bonus program to incentivize physicians to take on more patient care during each shift, enabling the company to "bill for and make more money. The program was motivated by the need to attract and retain the best possible physicians to the [TeamHealth] facilities and their markets, and was presented to the physicians as a way for them to make more money as well."
D.G. Pantazis Jr., JD, an attorney representing the physician plaintiffs, told MedPage Today that the preliminary settlement, which is expected to receive final approval in the coming weeks, "is a significant achievement for physicians nationwide."
The approving the preliminary settlement was signed March 11 by W. Keith Watkins of the U.S. District Court for the Middle District of Alabama.
In 2019, the court a motion from TeamHealth to dismiss the lawsuit, letting two of the three counts -- breach of contract and declaratory judgment -- go forward. However the court did grant TeamHealth's motion to dismiss the third count claiming "unjust enrichment."
Each physician will receive a share of the $15 million if they participated in a TeamHealth or an operating affiliate's RVU incentive plan from 2014 until the physician executed a new contract, and who had supervisory RVUs for which he or she was not paid.
According to the preliminary settlement terms, those class members who submitted a valid claim will receive a "pro-rata percentage of the unpaid RVUs according to the Defendants' coding and billing database." If approved, the settlement will pay any administration and attorneys' fees or costs awarded by the court, up to an agreed amount. Physicians who worked under contracts that specifically excluded such bonus payments will not be included in the payout.
Pantazis said it is unclear how much on average each physician will receive.
Attorneys' fees, , and other costs are to be subtracted from the $15 million. In a separate filing, the amount available for distribution to the emergency physicians was shown to be
In an email to MedPage Today, a TeamHealth spokesperson wrote, "TeamHealth has consistently denied all claims in the lawsuit and believes our clinicians were paid appropriately. We agreed to resolve the claims in this case to avoid the distractions of protracted litigation and focus our attention on continuing to provide outstanding patient care."
Last year, TeamHealth was sued by UnitedHealth, who alleged that systematic upcoding led to more than $100 million worth of overcharging.