In July 2017, United Healthcare stopped making payments for PC-CP to its non-par providers on its Medicaid lines of business. Palmetto Pathology Services, P.A., and its physicians including Dr. Michael Abels and FSP past-president Dr. Luis Rey, along with Steven Weinstein of K&L Gates (corporate counsel for Palmetto Pathology and the FSP), and trial counsel Patrick Montoya with Colson Hicks, filed a class action lawsuit against UHC in 2019. On behalf of all Florida non-par hospital-based pathology groups, the class action lawsuit sought payment from UHC for all past and future PC-CP Medicaid claims, per AHCA's published Medicaid fee schedule.
On October 23, 2020, a class action settlement was reached on favorable terms to the pathologists.
Dr. Mike Abels, one of the Palmetto litigants and an FSP Member wrote: “This victory would be hollow had Mort (Levitt, FSP President), you (Amy Young, FSP Lobbyist) and the (FSP) team not prevailed in rolling back the ACHA Medicaid fee schedule initiative. Everyone take a victory lap. Everyone be vigilant and watch payor policies.”
FSP counsel, Steve Weinstein, believes, "This is a significant win for all Florida pathologists who will now receive full PC-CP reimbursement from UHC on past and future Medicaid claims. Moreover, it demonstrates that Palmetto Pathology and (your Florida Society of Pathologists) are willing to fight to secure proper reimbursement for these medically necessary professional services, for which they are liable and must be paid."
Here are the terms of the settlement:
The legal team urges the pathologists to make their claims as soon as they receive the Class Notice stating that "The Settlement Agreement allows for claims to be made in the secured internet portal for 30 days from the date the Class Notice is mailed to the pathologists. So it is imperative that the groups watch their mail and make the claims timely in the internet portal. If a group does not make a timely claim, then it will be forever waived under the terms of the Settlement Agreement.”
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