Connecticut General Life Insurance and Cigna Health and Life Insurance filed the suit against three surgery centers, alleging Cigna overpaid the ASCs around $8 million. The ASCs allegedly waived patient payments for out-of-network bills but continued to bill the insurance company.
In April, the Texas-based ASCs filed a motion for the partial summary judgment, alleging no support for Cigna’s claims after more than a year. The motion stated: “Cigna’s plan interpretation is legally incorrect and cannot be enforced under ERISA 502(a)(3),” according to an SE Texas Record report.
The motion also argued Cigna’s overpayment provision has “inscrutable language” and highlighted different court opinions on whether overpayment prevision “facially creates an equitable lien by argument.”
The parties agreed to settle the case.
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