UnitedHealth Out-of-Network Surgical Fee Case Shrinks in N.Y.

UnitedHealth Group Inc. partly beat a lawsuit over its refusal to pay certain out-of-network surgical fees.

But a federal judge also tossed the insurer’s overbilling counterclaims against the physician plaintiffs.

The Medical Society of the State of New York can’t challenge UnitedHealth’s payment policies on behalf of 19 of the 66 patients the group sought to represent in its proposed class action alleging violations of the Employee Retirement Income Security Act, a Manhattan federal judge ruled March 28.

The lawsuit claims UnitedHealth breaches the terms of its employee health plans by refusing to pay “facility fees” that out-of-network surgeons charge ...