Three large physician groups joined a class action lawsuit against Cigna Corp, arguing that there has been intentional underpayment of medical claims submitted by patients through MultiPlan. MedTwitter
, arguing that there has been intentional underpayment of medical claims submitted by patients for services covered through MultiPlan, the nation's largest third-party network.
But the complaint alleges that MultiPlan failed to stick with that bargain. In a statement, AMA President Jack Resneck Jr, MD, said the physician groups joined the legal action"to shed light on Cigna's misconduct and create remedies so that patients and physicians can look forward to getting what they are promised."
According to the complaint, Cigna used a company called Zelis to"unilaterally re-price'' claims at an amount far lower than that called for by the MultiPlan Contract. The three cases cited in the lawsuit stem from a 2017 spine surgery in Washington and 2018 orthopedic and 2020 breast reconstruction surgeries in New Jersey.
Hufford, who’s a partner at law firm Zuckerman Spaeder, said that these kinds of cases fall beyond the protections provided by the No Surprises Act. Plaintiffs in these cases were enrolled in what are called self-insured plans provided by employers, through which they were supposed to be allowed to seek out-of-network care.
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