Plaintiffs filed an amended complaint in a pending ERISA class action lawsuit to include state law claims by the American Medical Association (AMA), the Medical Society of New Jersey, and the Washington State Medical Association. The original individual plaintiffs were participants in CIGNA-administered health plans and received medical care from physicians in the MultiPlan network. 

Physicians in the MultiPlan network agree not to hold patients liable for the difference between the billed charges and the discounted rate under the network. They allege that CIGNA often refuses to honor the billed charges and pays physicians at a discounted rate to which they had not agreed. In other words, they claim that CIGNA intentionally underpaid the insurance claims. The case is Stewart v. CIGNA, Case No. 3:2022cv00769 (U.S. District Court for the District of Connecticut). 

The AMA and other professional medical groups who have joined the suit claim that CIGNA has engaged in misconduct by shortchanging payments to MultiPlan physicians after they treat patients covered by the plan. They also allege that CIGNA has interfered with the patient-physician relationship by ignoring the MultiPlan contracts. CIGNA also reportedly advised patients that they were liable for the portion of the billed charges that CIGNA did not cover by sending them incorrect Explanations of Benefits (EOBs) concerning their claims. The groups claim that CIGNA’s actions amount to deceptive business practices. 

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