From CareFirst suing Johnson & Johnson over alleged anticompetitive biosimilar tactics to Humana accused of using an AI tool to wrongfully deny Medicare Advantage claims, here five lawsuits, settlements and legal developments involving payers that Becker's has reported since Dec. 5:
1. The Justice Department wants Humana's lawsuit challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans moved to a different court, then thrown out.
2. CareFirst BlueCross BlueShield filed a proposed class-action lawsuit accusing Johnson & Johnson and Janssen Biotech subsidiary of unlawfully delaying the introduction of biosimilar competition for ustekinumab.
3. Kraft Heinz voluntarily dismissed a lawsuit against Aetna alleging the payer breached its fiduciary duties and used its role as third-party claims administrator for Kraft's employee health plan "to enrich itself" to the food manufacturer's detriment.
4. A proposed class-action complaint accused Humana of using an artificial intelligence tool owned by UnitedHealth Group to wrongfully deny Medicare Advantage members' medical claims.
5. A Blue Cross and Blue Shield of Louisiana policyholder filed a proposed class action lawsuit seeking to block the insurer's sale to Elevance Health.