The three health insurers have been hit with lawsuits by the Healthcare Justice Coalition NJ, which claims that doctors are paid just a fraction of their bills for out-of-network services provided.
On Feb. 1, the CMS will send its initial offer of a fair price for each of the 10 selected prescription drugs to the drugmakers, who have all filed lawsuits attempting to block the government's effort to control drug prices.
The health insurer breached its contract and sought to unilaterally reduce its reimbursement rates to Envision, a company that staffs doctors in emergency rooms, according to an agreement by an arbitration panel.
The decision goes beyond the scope of a November 2020 ruling in "Loeb v. Vantage Custom Classics," which allowed a plaintiff to proceed with a whistleblower suit related to COVID, said Christopher Eibeler, the plaintiff's lawyer.
"I think it's going to force more companies to take a closer, more active look and engage themselves with pay equity more. And it will also give people more of a chance to say 'I don't think my pay is fair,' and engage on that issue," says attorney David Rapuano.
"Employers might not be as generous with time off as they were during COVID. I'm not sure monkeypox is going to require that. It's going to be interesting," said attorney Katherine Dudley Helms of Ogletree Deakins.
"Plaintiff, who had only been on the job for about six months, was one of four billing representatives from his department who PATHS determined could not work remotely because they needed supervision based on their lack of experience, a need for further training, and other issues," the judge said.