{"id":14816,"date":"2023-01-24T08:19:39","date_gmt":"2023-01-24T13:19:39","guid":{"rendered":"https:\/\/18fbf770e8.nxcli.io\/?post_type=whitepapers&#038;p=14816"},"modified":"2023-01-24T08:19:41","modified_gmt":"2023-01-24T13:19:41","slug":"%e4%b8%ba%e4%bf%9d%e9%99%a9%e8%af%89%e8%ae%bc%e4%b8%ad%e7%9a%84%e6%82%a3%e8%80%85%e6%8f%90%e8%ae%ae%e7%9a%84%e7%ad%89%e7%ba%a7%e8%ae%a4%e8%af%81","status":"publish","type":"whitepapers","link":"https:\/\/napolilaw.lemonadestand.org\/zh\/%e7%99%bd%e7%9a%ae%e4%b9%a6\/%e4%b8%ba%e4%bf%9d%e9%99%a9%e8%af%89%e8%ae%bc%e4%b8%ad%e7%9a%84%e6%82%a3%e8%80%85%e6%8f%90%e8%ae%ae%e7%9a%84%e7%ad%89%e7%ba%a7%e8%ae%a4%e8%af%81\/","title":{"rendered":"\u4fdd\u9669\u8bc9\u8bbc\u4e2d\u60a3\u8005\u7684\u62df\u8bae\u7b49\u7ea7\u8bc1\u660e"},"content":{"rendered":"<p>\u62df\u8bae\u7684\u6570\u5343\u540d\u60a3\u8005\u7c7b\u522b\u6307\u63a7 Cigna \u53ca\u5176\u8ba1\u8d39\u5408\u540c MultiPlan \u4e32\u901a\u5c11\u652f\u4ed8\u836f\u7269\u6ee5\u7528\u969c\u788d\u6cbb\u7597\u7684\u7f51\u7edc\u5916\u7d22\u8d54\uff0c\u4ece\u800c\u8fdd\u53cd\u4e86 ERISA\u3002 <\/p>\n\n\n\n<p>\u6b63\u5982 Law360 \u62a5\u9053\u7684\u90a3\u6837\uff1a <\/p>\n\n\n\n<p>The proposed class said that for all claims at issue, Cigna verified to patients&#8217; providers on the phone that claims for mental health and substance use disorder treatments would be reimbursed at what&#8217;s known as the &#8220;usual, customary and reasonable,&#8221; 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<p>\u90a3\u4e0d\u52d2\u65af Shkolnik \u9ad8\u7ea7\u52a9\u7406 <a href=\"https:\/\/napolilaw.lemonadestand.org\/zh\/%e5%be%8b%e5%b8%88\/%e6%b8%a9%e8%bf%aa%e7%b1%b3%e5%88%87%e5%b0%94\/\">\u6e29\u8fea\u00b7A\u00b7\u7c73\u5207\u5c14<\/a>l \u4e0e\u5176\u4ed6\u5f8b\u5e08\u4e8b\u52a1\u6240\u4e00\u8d77\u4ee3\u8868\u63d0\u8bae\u7684\u7c7b\u522b\u3002  <\/p>\n\n\n\n<p><a href=\"https:\/\/www.law360.com\/health\/articles\/1566791\/patients-seek-class-cert-in-cigna-benefits-underpayment-suit\" target=\"_blank\" rel=\"noreferrer noopener\">\u8bf7\u5728\u8fd9\u91cc\u627e\u5230\u539f\u59cb\u6587\u7ae0<\/a><\/p>","protected":false},"excerpt":{"rendered":"<p>\u62df\u8bae\u7684\u6570\u5343\u540d\u60a3\u8005\u7c7b\u522b\u6307\u63a7 Cigna \u53ca\u5176\u8ba1\u8d39\u5408\u540c MultiPlan \u4e32\u901a\u5c11\u4ed8\u836f\u7269\u4f7f\u7528\u969c\u788d\u6cbb\u7597\u7684\u7f51\u7edc\u5916\u7d22\u8d54\uff0c\u4ece\u800c\u8fdd\u53cd\u4e86 ERISA\u3002\u4f5c\u4e3a Law360\u2026\u2026<\/p>","protected":false},"featured_media":0,"menu_order":0,"template":"","whitepaper_category":[],"whitepaper-source":[63],"class_list":["post-14816","whitepapers","type-whitepapers","status-publish","hentry","whitepaper-source-law360"],"acf":[],"_links":{"self":[{"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/whitepapers\/14816","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/whitepapers"}],"about":[{"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/types\/whitepapers"}],"version-history":[{"count":0,"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/whitepapers\/14816\/revisions"}],"wp:attachment":[{"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/media?parent=14816"}],"wp:term":[{"taxonomy":"whitepaper_category","embeddable":true,"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/whitepaper_category?post=14816"},{"taxonomy":"whitepaper-source","embeddable":true,"href":"https:\/\/napolilaw.lemonadestand.org\/zh\/wp-json\/wp\/v2\/whitepaper-source?post=14816"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}