Employers are fighting for data that they say shows how their health plans overpay for care.
Kraft Heinz Co. accused CVS Health Corp.’s Aetna of wasting its money by paying fraudulent medical claims. Two union health insurance plans in Connecticut alleged that insurer Elevance Health Inc. routinely overpaid medical bills. And the trustees of a bankrupt trucking company accused insurer UnitedHealth Group Inc. of mismanaging millions of dollars.
After years of ever-inflating medical costs, American companies and union benefit plans have alleged in a series of lawsuits that the country’s biggest health insurers are squandering their money. What’s more, they argue that insurance companies refuse to hand over critical information about their medical claims when asked.
The cases reveal an emerging rift between employers that spend $1 trillion a year on health benefits and the insurance firms they hire to operate those plans: Some companies increasingly want to know where their money is going and what prices they pay for care, but insurers say they must keep those details private to stay competitive.
“It kind of makes you wonder, is there something that they're hiding that they won't release this information?” said Michael Thompson, a trustee who represents union contractors that pay into the Connecticut unions’ health plans suing Elevance.
Aetna, Elevance and UnitedHealthcare declined interview requests and wouldn’t comment on the cases. Elevance and UnitedHealthcare disputed the allegations in court filings, while Aetna hasn’t filed a reply yet.
Read the full article at Bloomberg News
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