Cigna Health and Life Insurance Company is urging a federal court to toss a radiology provider's lawsuit alleging the insurer wrongly denied payment for hundreds of thousands of dollars in COVID-19 services, Law360 first reported Thursday.
Open MRI and Imaging says the nation’s fourth largest commercial insurer violated New Jersey’s Employee Retirement Income Security Act when it refused to pay $398,665 in diagnostic services and treatment related to the coronavirus. Cigna, however, says the organization has failed to provide key information needed to back up its claims.
The Rochelle Park, New Jersey, lab first filed suit on Aug. 12, amending the complaint on Dec. 11 to include the ERISA violation assertions as well as those of unjust enrichment and quantum meruit, the news outlet reported.
Cigna, meanwhile, argues the medical provider hasn’t identified the patients behind the denied payments, adding that, among other complaints, many of the services cited by the lab refer to treatment performed before the pandemic.
“There is no articulation of a plan term that, if properly applied, would lead to plaintiff gaining the relief it seeks," Cigna said in a brief obtained by Law360. "And, if any of this information did appear, there is no allegation as to how this medical provider would have standing to assert the rights of its patients under their respective employee benefit plans."
Read more about the claims below.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.