UnitedHealth Out-of-Network Repricing Suit Advances After Trim

Units of UnitedHealth Group Inc. must face claims they enriched themselves at the expense of health plan participants by using third-party “repricer” companies to lower reimbursement rates for out-of-network medical providers and pocket the difference.

United argued its alleged repricing activities actually benefited patients by ensuring their health plans don’t overspend on out-of-network services. But this is a factual dispute that can’t be resolved in the early stages of litigation, and it doesn’t defeat the allegation that United’s conduct was “primarily motivated” by its desire to profit from a scheme that hurt patients, Judge Valerie Caproni said. HerTuesday opinion allows ...