Jury Awards Medical Group $9.4M For Health Plan Shortfalls

Law360 (August 19, 2020, 8:44 PM EDT) -- An Arkansas federal jury awarded $9.4 million Tuesday to an emergency physician group that said a health plan affiliate of Centene Corp. underpaid for medical care provided to policyholders and then concealed the existence of a contract governing reimbursement.

Southeastern Emergency Physicians LLC had sued Arkansas Health & Wellness Health Plan Inc., a Centene affiliate also known as Ambetter, in August 2017, saying that starting in 2015 Ambetter had drastically underpaid SE Physicians' bills for emergency care to the plan's patients.

The trial centered on a September 2011 contract between Ambetter affiliate NovaSys and SE Physicians' parent company TeamHealth, which provided...

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