Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/625027
J A N U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 5 w We inadvertently omitted Karl Storz and its Arthroscopy Imaging Platform (karlstorz.com) from "Thinking of Buying … Arthroscopy Imaging Consoles" (December, page 74). The platform com- bines state-of-the-art video innovations into high-definition, highly enhanced views of minimally invasive surgical sites. The company's proprietary CLARA technology automatically identifies and brightens the darker, less-illuminated areas of captured images in real time. This delivers a clear view of anatomical details without the need for adjusting a scope's brightness level — which can result in overexposure and glare — or stopping to move the scope, which nar- rows visibility. For the Record A $9,500,000 settlement has been reached in a class action lawsuit alleging that UnitedHealth Group Incorporated and Certain Subsidiaries and Affiliates ("Defendants") provided insufficient reimbursement for Covered Out-of-Network Services or Supplies rendered by Out-of-Network Ambulatory Surgery Centers, including by using certain reimbursement methodologies, policies, and practices (including, but not limited to, the HZ Methodology as indicated by remark code HZ on explanation of benefit forms) in determining reimbursement amounts for Covered Out-of- Network Benefits provided to members in healthcare plans insured or administered by the Defendants, and failed to adequately communicate and disclose the use of those reimbursement methodologies to Settlement Class Members. Defendants deny all of the Settling Plaintiffs' allegations and the Court has not decided who is right. Members of the Settlement Class have certain rights and may be eligible for a payment if they submit a valid Claim Form. Who's included? The Settlement Class includes Ambulatory Surgery Centers who furnished Covered Out-of-Network Services or Supplies to a member of a healthcare plan insured or administered by Defendants at any time after July 27, 2005, and submitted a claim for reimbursement for those Covered Out-of-Network Services or Supplies that was reimbursed at least in part by the Defendants using the HZ Methodology (as indicated by the HZ Remark Code on an explanation of benefits form). How to get a payment. The Settlement provides for payments from the Net Settlement Fund to members of the Settlement Class who do not opt out and who qualify and timely submit Claim Forms to the Settlement Administrator. In order to qualify for a settlement payment, you must complete a Claim Form, sign it, and mail it to the Settlement Administrator, postmarked no later than Wednesday, March 9, 2016. Claim Forms are available at the settlement website. Your other rights and options. If you do not want to be legally bound by the Settlement, you must exclude yourself from the Settlement Class by timely submitting an Opt-Out Request Form to the Claims Administrator. Your Opt-Out Request Form must be postmarked no later than Wednesday, March 9, 2016. If you do not exclude yourself, you will release all claims against the Defendants and will not be able to sue the Defendants for any claim relating to the lawsuit. If you stay in the Settlement Class, you may object to it by submitting your objection to Settlement Class counsel by Wednesday, March 9, 2016. The Court will hold a hearing on May 16, 2016 to consider whether to approve the Settlement and a request for attorneys' fees of up to thirty percent (30%) of the Settlement Fund, and reimbursement of costs and expenses not to exceed $125,000.00 and for approval of a Class Representative Fee to each of the Settling Plaintiffs not to exceed $20,000.00 per Settling Plaintiff. You may appear at the hearing, but you are not required to attend. You may hire your own attorney, at your own expense, to appear or speak for you at the hearing. Visit the website for detailed information on how to exclude yourself from the Settlement, object to it, or appear at the hearing. LEGAL NOTICE Ambulatory Surgical Centers who submitted claims for out-of-network services or supplies and were reimbursed under the HZ Methodology may qualify for benefits from a class action settlement www.DowneyClassAction.com P