- Docket No.
- District Court
- Washington Western
- Declaratory judgment that plaintiffs are not obligated to pay disputed claims
- Obtain damages
Why this Matters
The plaintiff, a health insurance company, argues that a clinical lab’s improper inflation of COVID-19 testing reimbursement amounts entitles the plaintiff to recover unlawful overpayments under the Employee Retirement Income Security Act. Major COVID-19 relief legislation specifies that health insurers must provide coverage for COVID-19 testing without requiring any cost sharing on the part of patients, and requires insurers to reimburse testing providers (both in- and out-of-network) for conducting such testing. However, the law’s requirement that health insurers pay an out-of-network provider of COVID-19 testing a “cash price” listed on their public website— rather than a market-determined price or amount keyed to Medicare payment rates — has the potential to inflate costs for out-of-network COVID-19 testing.
The lack of guardrails related to capping payment rates for out-of-network COVID-19 testing services can drive up the costs of such testing.
14 Major Filings
- MINUTE ORDER (Oct 31, 2022)
- Reply in Support of Motion to Preserve (Oct 28, 2022)
- Declaration of Kirk Thompson (Oct 26, 2022)
- Declaration of Nicole Phillis (Oct 26, 2022)
- Opposition to Motion to Preserve (Oct 26, 2022)
- DECLARATION of AMY WILCOX in support of MOTION for Order TO PRESERVE EVIDENCE (Oct 19, 2022)
- Declaration of Charlie Gokey (Oct 19, 2022)
- Declaration of Charlie Gokey Exhibits (Oct 19, 2022)
- Declaration of Christine Seifert in Support of Motion to Preserve Evidence (Oct 19, 2022)
- Motion to Preserve Evidence (Oct 19, 2022)
- Reply to Motion to Dismiss for Failure to State a Claim (Jun 10, 2022)
- ORDER SETTING JURY TRIAL DATE AND RELATED DATES (Apr 12, 2022)
- MOTION to Dismiss for Failure to State a Claim (Mar 10, 2022)
- COMPLAINT (Oct 14, 2021)