Prof. Daniel Schwarcz Quoted by NBC News About Doctors’ Battles With Insurers Over Reimbursements

Professor Daniel Schwarcz was quoted by NBC News about the behind-the-scenes battles doctors say they must wage with insurers over reimbursements and the increasingly aggressive tactics taken by huge payers like Minnesota-based UnitedHealthcare. In February 2024, a unit of UnitedHealth Group experienced a massive hack. The unit, Change Healthcare, shuttered its systems and halted all reimbursements owed to hospitals and doctors including Dr. Catherine Mazzola, a New Jersey pediatric neurosurgeon. To help providers stay afloat, Optum, another UnitedHealth Group subsidiary that includes a bank, began offering “temporary,” no-interest loans. Mazzola’s practice was among those tapping into the program — it received $535,000. Her practice began repaying the loans, but in January, Optum demanded that it repay the money in full and within five business days. She was then shocked to find the insurer had drawn up reimbursement checks payable to her practice and then deposited those checks into its own bank account. She feared bankruptcy, but in April the company stopped seizing reimbursements from her practice after she complained to the American Medical Association. Her experience also gives credence, antitrust experts say her experience gives credence to concerns that UnitedHealth Group’s acquisitions of an array of health care operations in recent years have given it too much power over patients and the doctors treating them. Prof. Schwarcz said the central question surrounding UnitedHealth Group’s reimbursement actions is “whether they abused their use of this remedy by insisting on repayment before it was appropriate for them to do so given the damages that they caused.”