Southern Regional Medical Center alleged in the lawsuit filed in Fulton County Superior Court that Cigna “systematically failed and refused to fully and properly pay” it for the reasonable value of the services it provided Cigna’s members from 2019 to May 2020, according to the report.
The medical center said that while Cigna paid for some claims, for hundreds of claims, it paid “far less than the reasonable value for those services.”
South Regional Medical Center is seeking the reasonable value of the medically necessary hospital services it provided — with the exact amount to be proven at trial — plus interest, according to the report. It is also seeking restitution and/or damages plus interest for Cigna’s alleged unjust enrichment and damages plus interest for the payer’s alleged breaches of implied contracts.
Becker’s reached out to Cigna for comment and will update this story if more information becomes available.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.