Cigna Gets $6 Million Covid Testing Reimbursement Suit Trimmed

A medical provider accusing Cigna Health & Life Insurance Co. of failing to cover more than $6 million in Covid-19 testing costs can sue the insurer under ERISA but not pandemic-specific federal legislation, a Connecticut federal judge ruled.

Neither the Families First Coronavirus Response Act nor the Coronavirus Aid, Relief and Economic Security Act authorize private parties to file a lawsuit claiming violations of the statutes, Judge Janet Bond Arterton of the U.S. District Court for the District of Connecticut held March 11.

Murphy Medical Associates argued that Congress’ “silence” on this point was “merely a product of its rush to create legislation in the midst of the pandemic,” but Arterton wasn’t persuaded.

Without “Congressional intent for a private right and remedy, ‘a cause of action does not exist and courts may not create one, no matter how desirable that might be as a policy matter, or how compatible with the statute,’” she said, quoting Alexander v. Sandoval.

However, Arterton allowed Murphy Medical to advance a claim for unpaid benefits under the Employee Retirement Income Security Act. The pandemic legislation “effectively modified the terms of ERISA plans to provide SARS-CoV-2 tests at no cost to a patient,” she said.

Murphy’s lawsuit claims it provided Covid testing services to more than 4,000 Cigna members and beneficiaries. Cigna is “blatantly defying federal law” by refusing to cover these testing services, which now total more than $6 million, Murphy claims.

Cigna disputed these allegations, saying Murphy is engaged in “price gouging” and an “elaborate business enterprise to exploit a national health emergency for profit.”

Arterton also allowed Murphy to advance a claim accusing Cigna of interfering with its contractual relationships by falsely spreading the word that the practice is a fraud.

Garfunkel Wild PC and Harris Beach PLLC represent Murphy. Robinson & Cole LLP represents Cigna.

The case is Murphy Med. Assocs. v. Cigna Health & Life Ins. Co., 2022 BL 82679, D. Conn., No. 3:20-cv-01675, 3/11/22.