Judge Dismisses Ballad Health's Lawsuit Against UnitedHealth Over Medicare Advantage Claims

A federal judge has dismissed Ballad Health's lawsuit against UnitedHealth Group over Medicare Advantage claims denials. The judgment, handed down by District Judge Clifton Corker, states that an arbitration agreement signed ahead of Ballad's formative merger still holds.

The agreement was made between UnitedHealth's affiliates and both Mountain States Health Alliance and Wellmont Health System. Ballad argued that the arbitration clause in these contracts was void because publicly funded Medicare Advantage plans are a matter of public concern, as well as that the clause was unenforceable due to UnitedHealth's material breach of the agreements.

Corker wrote that 'Ballad Health has not met its burden of showing a genuine issue of material fact as to the validity of the arbitration agreements. The arbitration agreements are valid.'

Ballad Health's lawsuit alleged that UnitedHealth had 'systematically denied, delayed or underpaid for care that physicians determined to be medically necessary' while reporting to the feds that patients were sicker than they were to secure additional payouts.