United States District Court for the Southern District of New York Rules Federal No Surprises Act Does Not Prevent Doctor Suing in State Court
The United States District Court for the Southern District of New York has ruled in Kennedy v. UnitedHealth Group, Inc., that a doctor can sue an insurer in state court for reimbursement on state law claims and that such state law claims are not preempted by the Federal No Surprises Act. Dr. Kennedy, an otolaryngologist, sued on state law theories of breach of implied-in-fact contracts and unjust enrichment for UnitedHealth unlawfully denying him payment for emergency medical services he provided to UnitedHealth plan patients in his capacity as an on-call physician. UnitedHealth wanted the case heard in federal court on the basis that the case involved recovery of payments under the Federal No Surprises Act, which was an exclusive remedy. UnitedHealth also argued that emergency services necessarily raised a federal legal question. The court rejected that the provision of emergency services necessarily raised any federal legal question and further ruled that the Federal No Surprises Act only dealt with patient claims for reimbursement from an insurer and not with a doctor's claims against an insurer. Therefore, the federal court ordered the case remanded back to a New York state court to hear the doctor's claims. The case is interesting in that it prevents an insurer from using the Federal No Surprises Act to force a doctor's reimbursement claims into federal court. You can read the complete court opinion in Kennedy v. UnitedHealth Group, Inc., here: Court Opinion Kennedy v United Health.
.png?sfvrsn=4447de7f_1)
