Aetna Network Services LLC et al. v. Poonia et al.

Docket No.
2:26-cv-06623
District Court
New Jersey

Goal

  • Award damages

Litigation Content

Why This Matters:

Why This Matters:

Health insurers allege that two doctors and their medical practices participated in a scheme to defraud the insurers out of tens of millions of dollars by abusing the No Surprises Act arbitration process to receive higher out-of-network payments, in violation of the federal Racketeer Influenced and Corrupt Organizations (“RICO”) Acts and New Jersey law. The higher than expected volume of arbitration cases to date and high provider win rate could raise health costs and plan premiums.

Potential Impact:

Potential Impact:

Actions that flout the intent of the No Surprises Act arbitration process through the submission of ineligible disputes could lead to higher costs and lower-quality care for patients.

Litigation Information

Current Status

Briefing is ongoing