Cigna has been hit with a proposed class action lawsuit over allegations the payer improperly denied COVID-19 testing claims, Lawstreet 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, according to the report. The plan member submitted the claim to Cigna, which paid $51.31. Cigna allegedly denied the remainder of the claim because there was a discount of $198.69 applied to the test that it negotiated.
The plan member said there was no discount, however, and he was forced to pay the remainder, according to the report. He attempted to contest the claim determination, arguing the test should have been fully covered under COVID-19 relief laws passed by Congress. Cigna allegedly responded by saying it paid the provider's normal charge. The plan member alleges that explanation contradicts Cigna's earlier reasoning.
The lawsuit accuses Cigna of claims processing in breach of fiduciary duty, failure to afford full and fair review, and failure to provide adequate notice.