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On Thursday, plaintiffs MISUB (SFH), Inc. doing business as Saint Francis Hospital (Saint Francis) and Saint Francis Hospital Bartlett, Inc. (Hospitals) filed a complaint in the Western District of Tennessee against Cigna Health and Life Insurance Company for breach of contract regarding Cigna’s refusal to reimburse the appropriate cost of emergency medical services for Cigna members.
Per the complaint, federal and Tennessee law both require hospitals offering emergency services to treat all patients who center an emergency room, regardless of insurance coverage.
The defendant, and other insurers are required by law to ensure their members receive emergency care when necessary. Cigna has agreed that the plaintiffs’ claims where reasonable and the medical treatments where necessary, however Cigna disagreed over the amount they are being asked to pay. Cigna is only disputing reimbursement for non-participating claims, according to the filing.
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