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UnitedHealth agrees to settle out-of-network lawsuits for $350M

UnitedHealth Group said this morning it will pay $350 million to settle claims that it left patients holding a bigger share of the bill than they should have for out-of-network doctor visits.

Earlier in the week, the Minnetonka-based HMO agreed to spend $50 million to settle an investigation by New York’s attorney general’s office. That money will fund a university-run database that will help insurers determine a fair reimbursement rate for non-network visits.

The New York settlement didn’t resolve the class-action litigation filed against the company by customers and medical groups, including the American Medical Association. The new settlement seeks to amend non-network claims since 1994.

When patients visit a doctor’s office outside their plan’s network, the insurer typically pays 70 to 80 percent of the cost. New York investigators accused the company of consistently low-balling the value of services provided.

UnitedHealth’s chief medical officer, Dr. Reed Tuckson, said in a statement that the company is “pleased to put these issues behind us so that we can focus on the important work of assisting physicians in their effort to provide the best possible, quality health care to their patients.”

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