Cigna Beats New Jersey Hospitals’ $100 Million Underpayment Suit

bgov.com

September 15, 2024 3:17 pm

Cigna Health & Life Insurance Co. defeated a $100 million lawsuit by hospitals that said they were underpaid for out-of-network medical services, when a New Jersey federal judge said the complaint didn’t point to specific language in Cigna’s health plans.

The hospitals, which are owned by New Jersey-based CarePoint Health Systems Inc., said Cigna had an intentional and unlawful pattern of underpaying them for emergency and elective services, with more than $100 million owed on at least 4,708 discrete claims. Judge Jamel K. Semper of the US District Court for the District of New Jersey dismissed the hospitals’ claims for benefits under the Employee Retirement Income Security Act in an unpublished order issued Thursday. He said they “do not point to, describe, or quote any language from the actual Cigna Plans that they claim entitle them to reimbursement.”

  • Semper also dismissed the hospitals’ claims for fiduciary breach and declined to exercise jurisdiction over their claims under New Jersey law
  • A different federal judge dismissed an earlier-filed complaint in the case last year