Cigna will face trial over a provider group’s allegations that the insurer did not pay $6 million in COVID-19 testing costs, according to a May 8 ruling in a Connecticut federal court.
Murphy Medical Associates filed its initial complaint against Cigna in November 2020. The practice had established COVID-19 testing sites in parts of Connecticut and New York. Murphy Medical argued the Families First Coronavirus Response Act and the Coronavirus Aid, Relief and Economic Security Act — as well as the Employee Retirement Income Security Act — required insurers to cover this testing.
On May 8, the judge dismissed claims brought by a patient found to not have Cigna coverage. However, the remaining claims will progress to trial. Prior to the May 8 order, Cigna said three other patients may also lack coverage, but the court did not consider them since the insurer brought up the concern for the first time in its reply brief.
Murphy Medical said it had appealed denials through Cigna’s internal process. While the insurer said it could not find those documents in Murphy Medical’s production, the judge said, “the defendants offer no evidence to suggest that records of these appeals do not exist within their own system, or that they conducted a search of their own system.”
The practice originally said Cigna owed $4.6 million but increased that amount to $6 million in an amended complaint from 2022. The most recent order said over 4,400 Cigna members had testing done.
Murphy Medical accused Cigna of making “defamatory and malicious statements,” as well. A few months after Murphy Medical’s initial complaint, Cigna accused the practice of price gouging. Murphy Medical also alleged reimbursement failures by Centene, but the judge eventually dismissed that case.
Becker’s has contacted Cigna and will update this story if more information becomes available.
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