Filing a lawsuit by a member - Chapter 2, 2021 UnitedHealthcare Administrative Guide

Lawsuits against a care provider

We do not automatically move the member to another medical group/IPA because of a lawsuit. We consider a transfer if:

• The complaint is about problems with quality of care or inappropriate behavior AND the care provider requests removal from their care.
• The transfer would not affect the member’s current treatment.
  • The treating care provider must confirm this.
  • The treating care provider must cooperate in the transfer of medical records and information to the new care provider.
  • The member wants another care provider who is part of the same medical group/IPA but located in a different office.

Lawsuits against a medical group/IPA

We do not deny the member access to care providers within a medical group/IPA because of a lawsuit. We consider a transfer if the member’s complaint is about problems with the general practices and procedures of the medical group/IPA.

Note: If you receive notification of a member’s plan to sue, notify your care provider advocate.

New York (NY) Domestic and Sexual Violence Hotline (only applicable to NY care providers who see Commercial and Oxford Health Plan members)

New York state law requires that all NY care providers post the Domestic and Sexual Violence Hotline information in their office. You can download the information at uhc.com/legal > New York > Members with a New York UnitedHealthcare insurance policy who may be in danger from another family member (pdf).