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Insurers Vie for Dismissal of Reimbursement Scheme Claims

Health your username 1 day ago The defendants of a case filed in April 2020, Cigna Behavior Health, Inc., and Multiplan, Inc., have responded to the initial complaint against them which alleged their involvement in a reimbursement scheme. The complaint was filed in the Northern District of California by a plaintiff known as R.J., who filed suit as the representative of her son and all others similarly situated. The complaint explained that R.J. and her son were covered under Cigna’s insurance plan, for which they paid a higher premium for a specific privilege that allowed them to choose out-of-network healthcare providers. The son, the complaint said, received treatment for his mental health and substance use disorders from out-of-network providers who were “licensed, accredited, treatment providers.” Despite their plan allowing this type of treatment, Cigna allegedly denied their coverage claims all while “reaping large profits from his [SJ’s] supposedly premier, gold

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