Class Action Filed Against Cigna for Denying Depression Treatment

Posted Sep 08 2015 by / Latest News / 0 Comments /

A class-action lawsuit has been filed against Cigna by Psych-Appeal, in conjunction with Zuckerman Spaeder LLP, on behalf of mental health patients suffering from depression. The federal lawsuit alleges Cigna has categorically refused to cover Transcranial Magnetic Stimulation (TMS), a safe and effective treatment approved by the U.S. Food and Drug Administration. The filing was made days after Psych-Appeal and Zuckerman Spaeder LLP filed a similar class action complaint against Aetna on Sept. 3.

“Although Medicare and numerous commercial insurers routinely cover TMS, Cigna has unjustifiably categorized this treatment as ‘experimental and investigational,’” said Brian Hufford, partner at Zuckerman Spaeder LLP. “By denying coverage for TMS and restricting patients from receiving potentially lifesaving treatment, Cigna is improperly elevating its own interests above the welfare of its members.”

The suit involves a 61-year-old woman who has tried multiple treatments for her severe depression. In 2008, the FDA cleared TMS for patients who have failed to respond to psychotropic medications. TMS, unlike electroshock therapy, is performed on an outpatient basis without sedation and does not typically result in side effects such as memory loss.

The complaint also alleges that MCMC, LLC, an independent review organization directly contracted with Cigna to evaluate external appeals of the company’s TMS denials, rubber-stamps the insurer by relying on outdated clinical research.

“In California alone, at least 75 external appeals to other independent review organizations have recognized TMS as a valid, evidence-based treatment for depression since 2011,” said Meiram Bendat, mental health attorney and founder of Psych-Appeal. “We expect this case to highlight the conflicts of interest that independent review organizations have when they are allowed to contract directly with insurers to evaluate claim denials.”

 

 

 

 

 

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