The OSCA along with many other state and national chiropractic associations filed a class action lawsuit against United Healthcare concerning their habits of taking money out of EOB’s for dollars they believed were owed. This lawsuit was filed in 2011. It is still an active lawsuit and is still being pursued. We have no real update at this time but if providers are still having issues with UHC taking money out of EOB’s please contact our office.
Last year the OSCA filed a class action lawsuit against Humana for similar issues. Humana was taking money out of EOB’s due to what they believed were overpayments in 2011. Our lawsuit argues that Humana is not owed that money back. This lawsuit is progressing and we have a hearing date on October 14th to argue our position. We will provide an update to our membership after that hearing.
If you are still having issues with Humana taking monies it is important that you appeal this decision.
The OSCA’s legal team has issued a letter to OPTUM and UHC stating that we do not feel the new Per Diem reimbursement model complies with state and federal rules. We are hoping we can stay the proposed change on November 1st. We will continue to inform our members on the developments of this matter.