\u63d0\u6848\u3055\u308c\u305f\u6570\u5343\u4eba\u306e\u60a3\u8005\u30af\u30e9\u30b9\u306f\u3001Cigna \u3068\u305d\u306e\u8acb\u6c42\u5951\u7d04\u3067\u3042\u308b MultiPlan \u304c\u5171\u8b00\u3057\u3066\u7269\u8cea\u4f7f\u7528\u969c\u5bb3\u6cbb\u7642\u306b\u5bfe\u3059\u308b\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5916\u306e\u8acb\u6c42\u3092\u904e\u5c0f\u306b\u652f\u6255\u3046\u3053\u3068\u3067 ERISA \u306b\u9055\u53cd\u3057\u305f\u3068\u4e3b\u5f35\u3057\u3066\u3044\u307e\u3059\u3002 <\/p>\n\n\n\n
Law360 \u304c\u5831\u544a\u3059\u308b\u3088\u3046\u306b: <\/p>\n\n\n\n
The proposed class said that for all claims at issue, Cigna verified to patients’ providers on the phone that claims for mental health and substance use disorder treatments would be reimbursed at what’s known as the “usual, customary and reasonable,” or UCR, rate. The UCR rate is a composite rate based on similar providers in the same geographic area. But when claims were later priced using a methodology of MultiPlan subsidiary Viant, reimbursements were calculated using much lower rates, the proposed class said, in a scheme that they allege violated the Racketeer Influenced and Corrupt Organizations Act.<\/p>\n\n\n\n
\u30ca\u30dd\u30ea \u30b7\u30e5\u30b3\u30eb\u30cb\u30af \u30b7\u30cb\u30a2 \u30a2\u30bd\u30b7\u30a8\u30a4\u30c8 \u30a6\u30a7\u30f3\u30c7\u30a3\u30fbA\u30fb\u30df\u30c3\u30c1\u30a7\u30eb<\/a>l \u306f\u3001\u4ed6\u306e\u6cd5\u5f8b\u4e8b\u52d9\u6240\u3068\u5171\u306b\u63d0\u6848\u3055\u308c\u305f\u30af\u30e9\u30b9\u3092\u8868\u3057\u307e\u3059\u3002 <\/p>\n\n\n\n