1. A Delaware judge dismissed a lawsuit from Cigna shareholders April 7 that claimed executives with the company fumbled a $1.85 billion termination fee after the failed $54 billion merger with Anthem in 2017. The judge ruled that stockholders did not prove it would have been pointless to demand an investigation of damage claims by the payer’s board.
2. An Arizona father is suing Anthem over the denial of behavioral health benefits for his daughter, who was admitted to a residential treatment facility. The father submitted claims for her treatment under his insurance plan with Anthem Blue Cross, but the payer denied the claim as not medically necessary. He alleges Anthem violated the Employee Retirement Income Security Act and the Mental Health Parity and Addiction Equity Act.
3. Louisiana’s attorney general filed a lawsuit April 13 alleging UnitedHealth inflates prescription drug charges in the state’s Medicaid program. The attorney general alleges UnitedHealth’s pharmacy benefits manager, Optum Rx, used secret prices and the complexity of the supply chain to cause the Medicaid program to needlessly pay billions of dollars more per year for prescription drug benefits. UnitedHealth said the lawsuit is without merit and it will defend itself against the allegations.
4. A woman who formerly worked as a utilization review nurse for Anthem filed a proposed class-action lawsuit against the company alleging that she routinely worked more than 40 hours a week without receiving overtime pay. She alleges Anthem violated Fair Labor Standards Act and New York labor law.
5. A federal judge in California April 13 reduced the chances of a proposed class action moving forward from drug abuse and mental health treatment providers against United Behavioral Health for allegedly denying coverage for medically necessary treatments. The judge dismissed all claims from the plaintiffs over health plans covered by the Employee Retirement Income Security Act and said they were preempted by federal law. The judge also dismissed misrepresentation and concealment claims over lack of evidence and wrote that plaintiffs “may face an uphill battle” with the other claims.
