After two New York physicians sued Cigna over a payment dispute, Cigna argued that an overpayment be returned and that the two physicians should be terminated from Cigna’s network.
The physicians rebutted citing the Employee Retirement Income Security Act (ERISA), stating they could not be terminated because they should be considered plan beneficiaries based on assignment of benefits by their patients.
However, the court ruled in favor Cigna because the plantiffs were not seeking payment in this case.
In an amicus brief filed by the AMA and State Medical societies, the court’s decision “threatens the ability of providers ever to assert any ERISA claim, even if the provider is designated by the plan and an insured as entitled to benefit payments.”
