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Judge Partially Grants Motion to Dismiss ERISA Underpayment Allegations Against Cigna, Viant

Judge Partially Grants Motion to Dismiss ERISA Underpayment Allegations Against Cigna, Viant
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Judge Dismisses Case Against United Health with Leave to Amend


Health
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December 21, 2020
In the Northern District of California on Friday, Judge Yvonne Gonzalez Rogers dismissed health insurance case against United Behavioral Health was dismissed with leave to amend. The judge dismissed the plaintiffs’ claims with prejudice under the Sherman Act and Racketeer Influenced and Corrupt Organizations Act (RICO) and the plaintiffs’ state law claims within the scope of the Employee Retirement Income Security Act (ERISA). Furthermore, the judge dismissed the plaintiffs’ state law claims regarding plans that fall outside the scope of ERISA with leave to amend.
The plaintiffs, led by Pacific Recovery Solutions, are out-of-network health care providers who provided intensive outpatient program (IOP) services to patients who had health insurance policies administered by United. At dispute was whether United represented to the plaintiffs that it would pay a percentage of the Usual, Customary, and Reasonable Rates (UCR) f ....

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