Health Diagnostic Laboratory asks court to dismiss $84 million Cigna lawsuit
Health Diagnostic Laboratory (HDL) has filed a motion asking a federal district court to dismiss an $84 million lawsuit filed by Cigna, a national health insurer, against the Richmond-based company.
In a 43-page motion filed Dec. 8 with the U. S. District Court in Connecticut, HDL says Cigna’s suit has no standing. “Under the mistaken guise of an ERISA fiduciary claim, Cigna attempts to use this suit to circumvent clear ERISA regulations governing benefit coverage denials, to obtain funds on its own behalf and to serve its own business ends,” HDL says.
ERISA refers to the Employment Retirement Income Security Act of 1974, which sets standards for employee benefits plans and provides an opportunity to be heard when claims are denied.
Cigna filed suit against HDL in October, accusing the company of a “fraudulent fee-forgiving scheme.” Cigna’s suit alleges that HDL encouraged Cigna plan members to use its out-of-network, diagnostic blood-testing services by not charging patients for their share of the cost. The result, said Cigna, were “exorbitant and unjustified charges” that defrauded the company out of $84 million.
In its motion to dismiss, HDL says, “In reality, this suit is motivated by Cigna’s personal desire to limit out-of-network providers of health-care services, such as HDL, that Cigna refused to allow to operate in-network. Cigna seeks to advance this goal by demanding compensatory damages for all of the money it has purportedly paid to HDL and by refusing to pay pending claims for health-care services already provided, without following regulatory requirements. “
Furthermore, the motion says, “Cigna claims it is somehow entitled to this windfall because HDL allegedly waived patients’ co-pays, deductibles and coinsurance obligations” but Cigna’s suit doesn’t point to any ERISA provisions that were violated —the very essence of an ERISA claim.”