Here are eight lawsuits involving payers posted by Becker’s Hospital Review since mid-February:
1. UnitedHealth improperly denied mental health claims, judge rules
A judge ruled that a UnitedHealth Group unit instituted guidelines that denied care to patients needing mental health treatment to cut costs.
2. Lawsuit: Anthem’s ‘deceptive marketing’ made patients think WellStar, Emory in network
An Atlanta law firm filed a lawsuit under the ACA that seeks to allow thousands of individuals with Anthem Blue Cross coverage to get a special enrollment period after they were “falsely” lured into plans that didn’t include certain providers, according to a March 4 complaint.
3. Insurer off the hook for California hospital’s $42M false claims settlement
A district court judge dismissed a lawsuit filed by Los Angeles-based Pacific Alliance Medical Center against its insurer for refusing to cover the hospital’s $42 million False Claims Act settlement and costs related to a federal investigation.
4. Anthem accused of sending massive checks to patients to force providers in network
San Clemente, Calif.-based Sovereign Health is suing Anthem and its Blue Cross entities for sending more than $1.3 million in payments to patients that is allegedly owed to facilities that treated them.
5. BCBS of Michigan accused of charging hidden fees
A nonprofit organization filed a lawsuit against Blue Cross Blue Shield of Michigan accusing the health insurer of skimming additional fees from the organizations, according to court documents.
6. UPMC sues Pennsylvania AG, says state can’t interfere in Highmark dispute
UPMC claimed Pennsylvania’s attempt to compel the health system to work with rival Highmark after a state-brokered agreement expires is an overstep of authority.
7. Aetna settles claims denial lawsuit for $6.2M
Aetna agreed to settle a class-action lawsuit that accused the health insurer of categorically denying depression treatment claims.
8. BCBS of North Dakota fires back at patients in air ambulance lawsuit
Blue Cross Blue Shield of North Dakota rejected claims in a lawsuit filed by a couple questioning the insurer’s reimbursement policy for medical flights.
Date: March 7, 2019