Cigna Health and Life Insurance Company fired back at a group of medical care providers that filed suit against the insurer over allegedly failing to reimburse the providers for their COVID-19 testing services, arguing to dismiss the case because — according to Cigna — the plaintiffs actually were overcharging for their testing services.
Murphy Medical Associates LLC and its subsidiary providers filed an amended complaint March 24 after their original filing in November 2020, hoping to recover more than $6 million for COVID-19 testing services from Cigna after the insurance company allegedly engaged the plaintiffs in “a paperwork war of attrition.”
“Cigna has made and continues to make voluminous frivolous and bad faith medical records and audit requests in response to every claim submitted by the Murphy Practice, in a clear effort to overwhelm the practice and to delay or avoid its payment obligations indefinitely,” the amended complaint alleged.
Cigna said it sees things differently. The motion to dismiss the amended complaint, filed Friday by Cigna and a Connecticut subsidiary, claimed that Murphy Medical Associates LLC and its subsidiary providers took advantage of the pandemic-induced public health crisis through price gouging the costs of COVID-19 testing. Cigna noted, however, that the plaintiffs’ alleged conduct went beyond coronavirus test billing, purporting that Murphy has billed for other services that were “unnecessary” or “never provided,” according to the motion. The insurer argued that it “took the entirely reasonable step of requesting that Plaintiffs provide records” of the services for which they submitted billing to Cigna.
“Purported inconvenience to Plaintiffs’ business enterprise is hardly justification to preclude Cigna from confirming that millions of dollars in fees were legitimate and billed properly,” Cigna asserted.
The defendant pointed out that the plaintiffs’ amended complaint did not identify any of the purported 4,000-plus Cigna beneficiaries tested by Murphy Medical or an affiliate and that Cigna’s records requests are to ensure the medical necessity of the providers’ services, noting that, in order to adequately plead their case, the plaintiffs would need to provide record of specific patients, plans, services, and amounts billed. Additionally, the insurer claimed that the plaintiffs have no express or implied private right of action to sue under the First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act.
Cigna, represented by Robinson & Cole LLP, requested that the court dismiss the amended complaint with prejudice and award fees and costs to Cigna.
