From a $200 million loss in court to potential class actions, here are five recent moves around lawsuits involving payers:
1. UnitedHealth subsidiary ordered to pay $200M
A Nevada court ruled in early April that UnitedHealth subsidiary Sierra Health and Life Insurance must pay $200 million to the estate of a now-deceased Las Vegas man who was denied coverage of proton beam therapy for his lung cancer diagnosis.
2. Centene wins lawsuit from shareholders over Health Net purchase
A federal appeals court ruled April 7 that Centene shareholders cannot cannot sue the payer or members of its board of directors for allegedly withholding information about its 2016 purchase of Health Net for $6.8 billion.
3. Centene sued for alleged failure to reimburse provider for COVID-19 tests
A Connecticut medical practice filed a lawsuit April 6 against Centene for allegedly violating state and federal law by failing to reimburse it for over $2.4 million of COVID-19 testing services.
4. Pennsylvania judge upholds proposed class action against Aetna, Princeton
A federal judge in Pennsylvania allowed a proposed class action to move forward March 30 against Aetna and Princeton (N.J.) University for allegedly seeking unlawful coverage reimbursements from beneficiaries who have won personal injury settlements in court.
5. UnitedHealth working to avoid class-action lawsuit from independent pharmacies
UnitedHealth Group is working to avoid a class-action lawsuit from around 1,000 independent pharmacies nationwide for alleged under-reimbursements totaling more than $100 million. OptumRx, the payer's pharmacy benefits manager, filed over 200 cases in California federal court in late March to force individual arbitration instead of a class action.