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Plan's Anti-Assignment Clause Blocks Provider's Lawsuit for Benefits
Thomson Reuters / EBIALink to more items from this source
Oct. 14, 2021

"Preapproval communications regarding the surgery indicated that coverage would be at out-of-network levels but did not specify reimbursement rates or payment terms. It is possible that disputes like this one may be alleviated by the Consolidated Appropriations Act, 2021 requirement for providers to furnish plans with good faith estimates and for plans to provide participants with advanced explanations of benefits." [Alkon v. Cigna Health and Life Ins. Co., No. 20-2365 (D.N.J. Aug. 3, 2021)]

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