Health Insurance

St. Vincent Seeks Higher Medical Bill Payments Arkansas Class Action

When Nicholas Dorado was injured in an auto accident, he discovered that the facility that treated him did not immediately submit the bills to his insurance company but looked for higher payments than those the insurance company was willing to make. This class action sues St. Vincent Community Health Services, Inc., St. Vincent Infirmary Medical  Read more

United Healthcare Takes Part of Accident Settlement to Reimburse Itself Class Action

If you are injured in an accident, and the insurer of the driver who was at fault grants you a settlement, can your health insurance simply take some of that settlement, whether or not you’ve been properly reimbursed for your losses? The complaint for this class action claims that UnitedHealth Group, United Healthcare Services, Inc.,  Read more

Anthem Blue Cross Payment for Emergency Non-Contracted Providers Class Action

Under California law, insurers must pay reasonable fees to medical providers for emergency services performed on one of their insureds, even if the medical providers are not part of their own networks. California laws also require prompt payment to medical providers. The complaint for this class action claims that Anthem Blue Cross complies with neither  Read more

Qualified Emergency Specialists Bill Collection from Insureds Class Action

What do you do when you have medical insurance, but the providers refuse to submit the claim to the insurer and instead pursue you for payment, using a debt collection company? Plaintiff Timothy Smith decided to bring this class action, against Qualified Emergency Specialists, Inc. (QESI) and Choice Recovery, Inc.  Read more

CareFirst Comprehensive Lactation Support Settlement

This settlement resolves a class action against CareFirst, Inc., Group Hospitalization and Medical Services, Inc., CareFirst of Maryland, Inc., and CareFirst BlueChoice, Inc. The complaint alleged that health plans of these companies did not properly cover comprehensive lactation support and counseling services (CLS) as required by the Affordable Care Act (ACA). In particular, the complaint  Read more

Blue Cross Blue Shield of Minnesota Benefit Reduction for Repayment Class Action

If a health insurance company believes it overpaid on previous benefits, can it reduce payments for current, unrelated benefits? The complaint for this class action says it can only if its plan authorizes it. The plan for Blue Cross Blue Shield of Minnesota (BCBSM) does not authorize it, the complaint says, and the reduced benefits  Read more

Washington Regional Medical Center Pursues Insured Patient for Higher Charges Class Action

This class action takes on another practice of the convoluted US healthcare system in which injuries sustained in a car accident may not be paid for by the injured person’s medical insurance. The complaint claims that plaintiff Curtis Randolph was treated at Washington Regional Medical Center (WRMC), a hospital within his insurer’s network, but that  Read more

Balance Billing for Out-of-Network Charges at In-Network Facilities Investigation

Have you been treated at an in-network hospital or emergency room that accepts your insurance, only to receive a surprise bill from out-of-network personnel or services? Have you presented your insurance card, paid your deductible, coinsurance or copayment, and then still received a bill for thousands of dollars that you had no idea you would  Read more

Manufacturers and Distributors Conspired to Raise Opioid Use RICO Class Action

The complaint for this class action begins by pointing out that, since 1999, there have been more than 183,000 opioid-related deaths in the US, or more than three times the number of US soldier who died in the Vietnam War. Its primary allegation is that the manufacturers and distributors of opioids have violated the Racketeering  Read more

Health Net Inadequate Substance Abuse Network Class Action

Plaintiff Kathleen Steinley’s family was insured with Health Net, Inc. But when she had to find a behavioral health and substance use disorder (BH/SUD) facility to treat her son upon his release from an acute psychiatric facility, she was unable to find one that would or could work with her insurance. The complaint for this  Read more