A Nevada judge on Wednesday rejected most of UnitedHealthcare’s bid to seal court documents in a legal fight against physician-staffing firm TeamHealth concerning emergency room doctors’ reimbursement, leaving most of the case’s record publicly available.
The ruling by Clark County District Judge Nancy Allf is a win for TeamHealth’s Houston-based lawyers at Ahmad, Zavitsanos, Anaipakos, Alavi & Mensing as well as thousands of doctors and other members of the public across the country who have taken interest in the case.
The hearing comes on the heels of a monthlong trial in November in which a jury found Minnesota-based UnitedHealthcare liable for unjustly enriching themselves, breaching an implied contract and engaging in unfair claims with respect to how they reimburse doctors at three TeamHealth-owned emergency room practices in the Las Vegas area. The jury found UnitedHealthcare liable for punitive damages and, after a second phase of the trial, awarded the TeamHealth affiliates $60 million — $20 million each — in early December on top of the $3 million in actual damages it awarded to TeamHealth during the first phase.
Although Judge Allf granted part of UnitedHealthcare’s motions, AZA partner Jason McManis, who handled the bulk of TeamHealth’s hearing arguments, said the ruling keeps in the public record about 95% of what UnitedHealthcare sought to seal.
The most important piece of information that will be public, McManis said, are claims files that “showed just how low” UnitedHealthcare reimbursed the Nevada plaintiffs.
The motion to seal ruling also comes as TeamHealth and UnitedHealthcare continue to battle in other courtrooms across the country — including two in Texas. The Las Vegas trial was the first to involve the compensation of emergency room doctors through employer-sponsored health plans, which cover the majority of insured Americans.
UnitedHealthcare is one of several insurer-defendants that TeamHealth is battling in court. But as the nation’s largest health insurer, UnitedHealthcare’s litigation against TeamHealth, 10 cases so far, may have the most far-reaching implications outside the courtroom — particularly as doctor organizations are challenging federal agencies’ enforcement of new legislation governing provider billing practices and how disputes between providers and insurers play out. One of the cases likely to be affected has been filed in federal court in Tyler.
“It was a great result … we think [it] is very important,” McManis told The Texas Lawbook after Wednesday’s hearing. “This [was] a public trial about something that’s of extreme public interest. United asked the court to hide its dirty laundry and the court saw through that, so we think the court got it right.”
UnitedHealthcare declined to comment.
Wednesday’s outcome was only the latest example of a series of mostly unsuccessful attempts by UnitedHealthcare to seal court records and exhibits from the case or bar media from the courtroom during the November trial.
“Trials are public and it’s the public’s business,” McManis said. “When we have to try a case like this to defend the rights of emergency room doctors — or any kind of doctor — that’s something that’s particularly important to the public. Everyone needs healthcare and everyone has the right to know what exactly is impacting the cost of healthcare.”
Since the November trial, McManis said hundreds of doctors from all kinds of practice structures — staffing firms, doctor-owned practices, clinics and solo practices — have reached out to TeamHealth’s legal team because they experienced the same reimbursement problems with UnitedHealthcare as the Vegas ER doctors. McManis estimated at least 50 doctors were from Texas.
“The entire provider community has taken notice of this verdict and wants to be able to defend their rights,” McManis said. “For the most part, they didn’t know there was anything they could do about this and now they’re going to be able to see that United is doing this to everyone, and not just them.”
At the hearing, AZA partner John Zavitsanos cited examples of groups that tuned into the proceedings: representatives of the 250,000-member American Medical Association, representatives of the 55,000-member Texas Medical Association and representatives of the 12,000-member Harris County Medical Society.
“In 30-plus years of practicing law, I’ve never had a case that has drawn as much interest coast-to-coast as this one,” said Zavitsanos, who is TeamHealth’s lead lawyer, during Wednesday’s hearing.
UnitedHealthcare’s lawyer, Lee Roberts of Las Vegas, argued Wednesday that United only wanted sensitive, proprietary information sealed — including strategic business plans and other information that would give competitors an advantage to access — as well as evidence never shown to the jury. Roberts said UnitedHealthcare only wanted to seal one entire exhibit and redact information from others.
“I think you’ll see we tried to be as limited as we could,” Roberts told Judge Allf. “We tried to follow the rules to only redact the minimum necessary to meet privacy concerns … while still maintaining the rest of the documents’ availability to the public.”
Zavitsanos challenged that characterization, pointing out that UnitedHealthcare even wanted to seal a Vince Lombardi quote that had made its way into court documents.
Judge Allf decided to seal or redact only information related to M&A targets, individual medical data and documents that included a reimbursement analysis related to the Atlanta market.
She denied UnitedHealthcare’s request to seal information related to anything that was publicly disclosed (including information the lawyers displayed during opening statements and closing arguments), reimbursement rates, allowed amounts, and amounts billed.
“The insurance company is highly regulated, [and] very competitive,” Allf said. “The business models are all almost identical. And the defendant is a publicly traded company. It was clear to me during the trial that insurance companies know a lot more about each other. They learn those metrics. Their business model is identical, their metrics are identical.”