From settlements to denying a motion to dismiss, these are eight recent actions around proposed or approved class action lawsuits against payers:
7 payers face proposed class action aimed at forcing medical cannabis coverage
A New Mexico medical cannabis company and six medical patients filed a proposed class action June 10 against seven payers (Blue Cross and Blue Shield of New Mexico, True Health New Mexico, Cigna, Molina Healthcare of New Mexico, Presbyterian Health Plan, Presbyterian Insurance and Western Sky Community Care) they say should be covering medical cannabis costs as a behavioral health service. The lawsuit focuses on state legislation passed in 2021 that requires payers to cover 100 percent of behavioral health services and all prescribed treatments.
Blue Cross of California accused of improperly denying COVID-19 reimbursements
Blue Cross of California is facing a lawsuit for allegedly denying and underpaying for COVID-19 testing, Law Street Media reported June 6. The proposed class-action lawsuit was filed by Newark, Calif.-based Saloojas, an out-of-network laboratory that operates seven specimen collection sites.
Judge greenlights class action against Aetna over alleged disability benefits clawbacks
A federal judge in Pennsylvania approved a class-action lawsuit against Aetna on May 25 for allegedly violating the Employee Retirement Income Security Act by forcing disability benefits recipients to return personal injury payments received through legal settlements.
Settlement OK'd in Anthem Blue Cross eating disorder class action
A federal judge in California approved a class-action settlement requiring Anthem Blue Cross to reprocess claims for eating disorder treatments or pay up to $5,500 for denied claims, Bloomberg reported May 25. The class-action lawsuit accuses the payer of wrongly refusing to cover residential eating disorder treatment by relying on medical necessary criteria that conflicted with generally accepted standards of medical practice.
Proposed class action against BCBS Illinois alleges LGBTQ fertility coverage discrimination
A proposed class action filed May 19 alleges the plaintiff, her partner and other LGBTQ members are being forced by BCBSIL to pay out of pocket for one year of medically based and supervised methods of conception before the payer will provide coverage for fertility treatments because they cannot conceive through intercourse.
Cigna accused of improper COVID-19 testing claim denial
Cigna was hit with a proposed class-action lawsuit over allegations the payer improperly denied COVID-19 testing claims, Law Street Media reported May 18. The lawsuit was filed by a Cigna plan member, who paid $250 out of pocket for a COVID-19 test from an out-of-network provider in January.
Oscar Health concealed COVID-19 financial woes before IPO, investor lawsuit claims
An Oscar Health stockholder filed a proposed class action May 12 in the Southern District Court of New York, alleging the insurtech company misled investors about financial issues caused by COVID-19 ahead of its initial public offering in March 2021.
Pennsylvania judge upholds proposed class action against Aetna, Princeton for alleged unlawful reimbursement demands
A U.S. district judge for the Eastern District of Pennsylvania partially denied a motion March 30 to dismiss a proposed class-action lawsuit against Aetna and Princeton (N.J.) University for allegedly seeking illegal benefit reimbursements from beneficiaries who have won personal injury settlements in court.