Judge tosses billing lawsuit against TeamHealth

Judge revives Georgia's Medicaid work requirements policy


A federal judge dismissed the lawsuit filed by the Louisiana Municipal Risk Management Agency against TeamHealth on Friday, ruling that the plaintiff does not have standing to sue.

Judge Clifton Corker handed down the decision in the U.S. District Court for the Eastern District of Tennessee, writing that the plaintiff could not advance the lawsuit because the reimbursements in question came from government entities, not the Louisiana Municipal Risk Management Agency, which administers benefits for local government employees in the Pelican State.

The Louisiana Municipal Risk Management Agency sued TeamHealth in March, alleging the Knoxville, Tennessee-based provider group violated federal law by inappropriately billing for “tens, if not thousands, of hundreds of thousands of claims” and operating under an opaque corporate structure. The agency sought class-action status to represent every self-funded employer that paid for TeamHealth’s services over the last four years.

The plan administrator’s allegations mirrored those made by UnitedHealthcare, which has sued TeamHealth multiple times with varying success. The nation’s largest insurer notched a legal win against TeamHealth in May when Corker tossed the provider group’s motion to dismiss the case against it.

The Louisiana Municipal Risk Management Agency’s lawsuit differs from UnitedHealthcare’s complaint, Corker wrote in his opinion Friday. Because the agency did not serve as a fiduciary for local governments’ plans, the administrator did not directly or indirectly suffer because of TeamHealth’s alleged upcoding, Corker wrote.

“Louisiana Municipal Risk Management Agency hinges its argument on the fact that it paid TeamHealth’s invoices. But LMRMA, by its own admission, paid those invoices with the local governments’ money. The court fails to see how LMRMA was injured when it never was at risk of losing its own assets,” Corker wrote.

TeamHealth and the Louisiana Municipal Risk Management Agency did not immediately respond to interview requests.



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Marie Maynes
Marie Maynes is a Sports enthusiast and writes for the Sports section of ANH.