On Wednesday, plaintiff Enigma Management Corporation also known as Alliance Laboratory (Alliance), filed a complaint in the Supreme Court of New York, Kings County against the defendants Cigna Health Management Inc., Cigna Healthcare, Inc., and Cigna Holding Company (Cigna), for breach of contract, unjust enrichment, and declaratory judgment related to Cigna’s alleged refusal to pay Alliance for testing COVID-19 specimens.
Alliance is a clinical laboratory, according to the complaint, and Cigna is a global health insurance company. The plaintiff received hundreds of specimens from multiple individuals and medical providers for COVID-19 testing. Alliance claimed all specimens came with requisition forms filled out by medical providers, including Cigna. Alliance tested the specimens for COVID-19 and submitted claims of service to the defendants.
Cigna acknowledged receipt of the plaintiff’s claims of service, but refused to pay for the services unless Alliance provides a complete medical record from the patents who’s specimen were tested for COVID-19.
Alliance claimed they never had contact with the patients, only the specimens; therefore they do not complete medical records for the patients. Allegedly, Cigna refused to pay for any services without the medical records.
Per the complaint, “Section 6001 of the Families First Coronavirus Response Act (FFCRA), generally requires health insurance issuers offering individual health insurance coverage to provide benefits for certain items and services related to testing for the detection of COVID-19 when those items or services were furnished on or after March 18, 2020.”
Since Alliance claimed they provided the specimen testing, and the defendants are the insurance providers of the patients whose specimens were tested for COVID-19, Alliance claimed they are entitled to payment for the testing from Cigna.
The plaintiff is represented by the Law Office of Roman Popik, P.C. The instant action is brought under the FFCRA for breach of contract, unjust enrichment, and declaratory judgment.
The plaintiff is seeking declaratory judgement in their favor; a money judgement in their favor of an amount of at least $300,000 plus interest from March 18, 2020 and attorneys’ fees.
