Federal investigators claimed several companies administering small business health plans failed to pay more than $26 million in medical bills.
As a result, the Department of Labor ordered the defendants — AEU Holdings and AEU Benefits, or "AEU," and Black Wolf Consulting — stop administering employer plans. The department also obtained a temporary restraining order against the companies, and appointed an independent fiduciary to oversee the defendants' plans and ability to cover outstanding claims.
Member complaints tipped off the department to the companies' alleged payment failures. Federal investigators discovered employee and employer payments for the health policies were allegedly pooled and sent to offshore bank accounts. As of October, the companies had more than $26 million in processed, but unpaid, claims for services patients received beginning in January 2016, the investigators claimed.
The Department of Labor did not offer an exact number of members' missing payments. At their highest point, the companies covered about 14,000 members across 560 employers in 36 states.
More articles on payer issues:
Humana's net income up 11% in Q3
AmeriHealth Caritas to lay off 400, cease Iowa Medicaid management
Humana sues CMS for $600M+ in risk corridors payments