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FLORIDA RECORD

Thursday, April 18, 2024

Judge: No order shielding substance abuse treatment center A New Start vs United Healthcare in billing dispute

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MIAMI -- A federal judge has denied a request by a Palm Springs-based substance abuse treatment center for a protective order, shielding it from United Healthcare's demands for claims-supporting documents - a demand the treatment center said amounted to "improper discovery."

A New Start Inc.(ANS),  a third party defendant in a claim filed by United Healthcare Services over an alleged billing scheme, filed a motion Feb. 25 for a protective order in U.S. District Court for the Southern District of Florida in Miami.

U.S. Magistrate Judge Lauren Louis denied the motion, ruling in part: "ANS has not demonstrated its entitlement to a protective order as it has identified no discovery request from which it is entitled to protection."

According to court paperwork, United implemented a "pre-payment review" in November 2018, a full year after ANS became a third party defendant in a suit involving Living Tree Laboratories and United. 

The pre-payment review requires ANS to submit to United supporting medical records for all claims submitted by ANS since initiation of the review, court documents say. However, ANS contends this practice “represents improper discovery”. The company argues United has implemented the review "for the purpose of oppressing ANS and starving it out of the litigation and out of business." Furthermore, ANS alleges the review is not “permissibly sought through the discovery process” but rather through “self-help and subterfuge.”

Louis found, however, that "ANS’s generalized reference to the prepayment review and exemplary letter fails to specify what request ANS seeks the court’s protection from. Though ANS evidences that it has received and processed 126 such requests to date and anticipates receiving more requests, the motion does not identify what requests it claims are pending and still capable of being avoided, nor the specific information or documents those requests seek. This failing, however, is subsumed in the larger problems presented by the motion."

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