From the Labor Department suing a UnitedHealth Group subsidiary over emergency claims denials, to members suing Cigna following a ProPublica report on unreviewed batches of denied claims, here are seven lawsuits and settlements involving payers Becker's has reported since July 10:
1. A New York State Supreme Court judge permanently blocked the implementation of New York City's plan to switch 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan.
2. Altamonte Springs, Fla.-based AdventHealth is suing MultiPlan for an alleged ongoing conspiracy among commercial health insurers to reduce the reimbursement rates they pay to providers for out-of-network services.
3. Riverdale, Ga.-based Southern Regional Medical Center is suing Cigna, alleging the payer did not fully reimburse SRMC for medically necessary services as an out-of-network provider.
4. UnitedHealth Group subsidiary UMR incorrectly denied emergency room and urinary drug screening claims for "thousands," the U.S. Department of Labor alleged in a lawsuit filed in a Wisconsin federal court.
5. Two Cigna members filed a class-action complaint against their insurer for allegedly denying large batches of members' claims without individual review, thereby denying them coverage for certain services.
6. The CEO of a laboratory company acquitted in a $1.4 billion fraud scheme is suing six payers, alleging they made false allegations to regulators and prosecutors to avoid paying millions in legitimate claims.
7. A federal judge in Connecticut denied a class-action bid against Cigna for allegedly overcharging members for medical equipment and violating its fiduciary duties under the Employee Retirement Income Security Act.