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Texas AG Paxton Launches Investigation into TriWest Health Insurance Claim Denials

Texas AG Ken Paxton has launched an investigation into TRICARE Insurance’s TriWest Healthcare Alliance Corp. (TriWest), a private company contracted by the U.S. government to administer health care programs for military members, veterans, and their families, manages the U.S. Department of Veterans Affairs (VA) Community Care Network, and serves as the support contractor for the…

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Arizona AG Says Insurers Used Algorithm to Fix Out-of-Network Rates

Arizona AG Kris Mayes sued MultiPlan and several major health insurers, alleging violations of the Arizona Uniform State Antitrust Act and Arizona Consumer Fraud Act based on an alleged price-fixing scheme to suppress payments for out-of-network care. According to the complaint, the insurers allegedly used MultiPlan’s shared pricing algorithm and pooled confidential claims and payment…

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Massachusetts AG Accuses UnitedHealthcare of Inflating Medicaid Reimbursements

Massachusetts AG Andrea Joy Campbell sued UnitedHealthcare Insurance Company, d/b/a UnitedHealthcare Community Plans of Massachusetts, asserting Massachusetts False Claims Act, unjust enrichment, and breach of contract claims over allegations that the insurer inflated health-status assessments for seniors enrolled in its MassHealth Senior Care Options plan. According to the complaint, UnitedHealthcare improperly moved members into higher-paying…

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FTC Nets $145M to Resolve Deceptive Online Health Insurance Marketing Claims

The FTC has reached proposed settlements with Assurance IQ, LLC and MediaAlpha, Inc., resolving allegations that the companies misled consumers into buying health insurance plans without the promised coverage and subjected many to unwanted telemarketing and robocalls. In its complaint against Assurance, the FTC alleged that the company violated the FTC Act and the Telemarketing…

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NY Settles With Insurer on Data Breach Rooted in Security Deficiencies

New York AG Letitia James settled with Root Insurance Company to resolve allegations that the company’s data security deficiencies led to a 2021 data breach involving 72,000 people, in violation of state consumer protection and data security laws. According to the settlement, Root inadequately safeguarded personal information that its online automobile insurance quoting tool prefilled…

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