The American Medical Association (AMA) has joined a class-action lawsuit against Cigna, alleging the insurer underpaid for claims filed by providers in the contracted MultiPlan network.
MultiPlan is the country's largest third-party network, and Cigna contracts with it to access providers. According to the lawsuit, which was initially filed in June, Cigna reimbursed for claims from providers in MultiPlan's network at its non-participating providers rate rather than at the rate expected for a MultiPlan contract.
As such, the insurer "significantly underpaid claims, and put patients at risk of balance billing," the plaintiffs claim.
"It also breached its fiduciary duties, including its duty to honor written plan terms and its duty of loyalty, because its conduct serves Cigna’s own economic self-interest and elevates Cigna’s interests above the interests of plan member patients," according to the lawsuit.
Cigna had not returned a request for comment on the lawsuit at the time of publication.
In addition to AMA, two state medical societies—the Medical Society of New Jersey and the Washington State Medical Association—joined the suit. In a statement, AMA President Jack Resneck Jr. said that Cigna "has allowed the insurer’s economic self-interest to be prioritized ahead of their promises to physicians in the MultiPlan Network and their patients."
"The AMA and other physician organizations allege that Cigna’s misconduct is riddled with conflicts of interest and manipulations that routinely shortchanged payments to MultiPlan Network physicians and interfered with the patient-physician relationship by ignoring the MultiPlan contracts and making incorrect statements to patients about their liability for the unpaid portion of the billed charges," Resneck said. "By joining Stewart v. Cigna as a plaintiff, the AMA hopes to shed light on Cigna’s misconduct and create remedies so that patients and physicians can look forward to getting what they are promised.”