Patients and Behavioral Health Providers Sue Viant, Cigna and United for Conspiring to Underpay Out-of-Network Claims
The landmark suits allege the insurers used Viant to get around NY Attorney General's 2015 settlement with United over illegal reimbursement practices.
SAN FRANCISCO, April 6, 2020 /PRNewswire/ -- Napoli Shkolnik PLLC, a national law firm, filed 4 class action lawsuits alleging United Behavioral Health (United) and Cigna Behavioral Health, Inc. (Cigna) have both conspired for years with Viant, Inc. (Viant) to perpetrate a fraud upon patients and out-of-network behavioral health providers who offered outpatient care.
The suits were just filed in the U.S. District Court for the Northern District of California. Plaintiffs are seeking damages on behalf of nationwide classes of patients and providers. The suits are brought under federal and state laws including Employee Retirement Income Security Act (ERISA), the Racketeer Influenced and Corrupt Organizations Act (RICO), the Sherman Antitrust Act and California's Unfair Business Practices statute.
The conspiracy affected the payments of reasonable and customary rates in healthcare and has resulted in below market payments to providers and hundreds of millions of dollars in total balance bills for patients across the country. These illegally low payments violate the terms of patients' insurance plans and promises that were made to providers regarding rates for covered services. Plaintiffs allege that the insurers used Viant as a middleman to systematically reduce payments for substance abuse and mental health treatment to less than 5% of what providers were actually owed.
Two of the cases are brought by patients against United and Viant and Cigna and Viant, respectively, and two are brought by behavioral health outpatient providers against the same defendants.
Representative plaintiffs in the patient suits include health plan members from some of the most respected technology companies in Silicon Valley, including Apple, Inc., Tesla, Inc. and Inuit.
All of the behavioral health providers identified as plaintiffs in the suits are highly respected, licensed outpatient programs, and all accredited by the Joint Commission on Accreditation of Healthcare Organizations.
Lead Attorney Matt Lavin says of the case "Cigna and United's use of Viant to systematically underpay treatment costs for addicts and the mentally ill is, sadly, just today's example of insurers placing profits before behavioral health patients. Regulators have so far ignored complaints from patients and providers alike, so our clients are left with no alternative but to seek justice in the courts for themselves and for the millions of others who have been harmed by these unethical practices. We are confident the federal court will put an end to this practice once and for all and sufficiently punish these defendants, so they don't try it again."
All the cases allege that the Viant scam rose to prominence after then NY Attorney General Andrew Cuomo put an end to the insurance companies' Ingenix underpayment racket in 2015. According to the complaints, Cigna and United replaced Ingenix with Viant to justify ripping off insurance customers by manipulating benefits by applying secret rates that are arbitrary, deceitful, self-serving, and harmful to patients, all in order to grow profits and steer patients to in-network providers who cost the insurers less.
The complaints can be found here: PRS, et. al. v. United, et al, case 3:20-cv-02249, PRS, et al. v. CIGNA, et. al., case 3:20-cv-02251, LD, et. al. v. United, et. al., case 5:20-cv-02254, and RJ v. Signa, et. al., case 5:20-cv-02255.
If you are a healthcare provider and believe that Cigna, Viant, United, or any other commercial insurance company, has wrongfully underpaid your claims, we encourage you to call us.
About the firm
Napoli Shkolnik PLLC is a national litigation firm providing representation to plaintiffs in class actions and complex commercial litigation, as well as victims of environmental contamination disasters, aviation accidents, defective prescriptions drugs and medical devices, asbestos-related illnesses, unfair insurance practices and other serious personal injury matters. With their principal offices in New York City and additional offices in California, Florida, Illinois, Michigan, New Jersey, Ohio, Texas, Washington DC and affiliates throughout the United States, Napoli Shkolnik PLLC is readily available to clients.
SOURCE Napoli Shkolnik PLLC
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