Unions suing Elevance Health for allegedly restricting access to claims data

Labor unions contracted with Elevance Health for self-funded plans are suing the payer, alleging Elevance Health does not allow self-paid plans to access their own claims data and charged the self-pay plans higher rates than it had negotiated with hospitals. 

Law firm Berger Montague represents Bricklayers and Allied Craftworkers Local 1 Fund and Sheet Metal Workers Local 40 Fund, two unions who contracted with Elevance Health for access to the payer's network and negotiated rates. 

According to a Dec. 7 news release from Berger Montague, the two unions separately negotiated with Elevance for months for access to their health claims data, which they said they are required to review per the Employee Retirement Income Security Act. 

The unions allege Elevance engaged in negotiations with no intent to provide the data. 

According to the press release, trustees of both self-funded plans compared prices paid to negotiated prices available in transparency data. The unions allege the hospital-negotiated rates with Elevance, previously known as Anthem, did not match the rates the self-play plans were charged. 

"Anthem failed to apply the promised discounts found in each health plan's administrative service agreement and failed to pass on the entire discount to which each plan was entitled based on the negotiated rates between Anthem and the providers in the Anthem network," the law firm said in its news release. 

The lawsuit was filed Dec. 5 in Connecticut District Court. 

Elevance Health did not immediately respond to a request for comment from Becker's.

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