Payers are challenging contract decisions and noncompete agreements in court.
These are six legal updates involving payers Becker's has reported since Feb. 1:
- BCBS North Carolina is challenging the state's decision to hand its state health plan contract to Aetna. The payer filed a petition in Durham County court and the North Carolina Office of Administrative Hearings Feb. 16, alleging the state used an arbitrary system to select the administrator for its health plan serving 740,000 employees.
- A federal judge granted Cigna a temporary restraining order in its lawsuit alleging former executive Amy Bricker's departure to rival CVS Health violated a noncompete agreement.
- The Pennsylvania Insurance Department fined Highmark $205,000 for violations including incorrectly denied claims, untimely payments and violations of mental health parity requirements.
- Centene will pay California $215 million, the largest payment the company has made to settle allegations it overcharged state Medicaid programs. Centene has paid at least 14 states to settle allegations it overcharged Medicaid programs for prescription drugs by failing to pass discounted rates on to states.
- A federal judge in Texas handed another win to the Texas Medical Association and medical providers nationwide against HHS over a challenge to the arbitration process between out-of-network providers and payers that was established under the No Surprises Act.
- Centene has agreed to pay Indiana more than $66 million to settle allegations it overbilled the state's Medicaid program for pharmaceutical services.