Hospital Demands $15 Million From Cigna

     HOUSTON (CN) – Cigna shorted a Houston hospital by more than $15 million on insurance claims, the hospital claims in a federal lawsuit against dozens of Cigna-administered health plans.
     Humble Surgical Hospital sued more than 50 health plans Tuesday, seeking payment under the Employee Retirement Income Security Act, which covers health insurance disputes.
     Since opening in 2010 Humble Surgical has been among the top five hospitals in the Houston area, it claims, citing a Press Ganey patient satisfaction study.
     Humble is 25 minutes northeast of Houston.
     The hospital is an “out-of-network hospital, [and] has no contract with Cigna or the ERISA plans,” the complaint states.
     Humble Surgical claims that in an effort to coerce it to accept “less than the reasonable and customary” rates for its out-of-network services, Cigna has underpaid or denied more than 250 claims, totaling roughly $15 million.
     “In most instances, neither defendants nor their agent, Cigna, have provided a specific reason why the claims were denied,” Humble Surgical says in the 118-page lawsuit.
     It seeks damages for ERISA violations and an injunction requiring defendants to stop denying its claims.
     It is represented by Edward O’Neill Jr. with Pierce O’Neill of Houston.

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