Cigna, claims processor settle chiropractor lawsuits for $20M

Cigna and its third-party claims administrator American Specialty Health agreed to a $20 million settlement that resolves two lawsuits concerning payment for chiropractic care, according to the North Jersey Record, part of the USA Today network.

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A federal judge in Pennsylvania approved the agreement to settle two class-action lawsuits chiropractors filed against Cigna and American Specialty Health. Neither organization admitted wrongdoing in the agreement. In addition to the $20 million payment, the judge said the two organizations agreed to take steps to reform certain aspects of their businesses.

One of the lawsuits, filed in the U.S. District Court for the Southern District of California in 2018, accused Cigna and the claims processor of colluding to overcharge members of Cigna’s employer-sponsored health plans for what appeared to be medical expenses for therapy services, but were actually charges for American Specialty Health’s services. Plaintiffs accused Cigna and American Specialty Health of breaching their Employee Retirement Income Security Act duties by concealing material information about American Specialty Health’s charges from members and plans on their explanation of benefits documents.

American Specialty Health made headlines recently when Horizon Blue Cross Blue Shield of New Jersey sued a physician advocacy group after the group urged patients to fight the insurer’s new contract with the claims processor.

Read more here.

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