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Providers sue Cigna over alleged $12.8 million addiction claims shortfall
The complaint alleges Cigna paid about 16.4% of aggregate covered charges for 83 patients, leaving more than $12.8 million still owed.
Ten out-of-network substance use disorder treatment providers and clinical laboratories are suing Cigna, alleging the insurer paid them only a fraction of their covered charges for addiction-related care.
According to the complaint filed August 19, 2026 in the US District Court for the Central District of California, the claims cover 83 patients treated between March 1, 2022 and March 15, 2026 in California.
The filing says Cigna paid each provider between 0% and 28.29% of covered charges and that, as a group, the providers received 16.42% of aggregate covered charges of $15,338,175.60, leaving a balance they say is still owed of $12,819,098.17.
The complaint attributes the alleged shortfall to Cigna reimbursement approaches it calls “Maximum Reimbursable Charge,” and it argues that one method was effectively unavailable because Medicare had no rates for the specific services during the relevant period, according to the plaintiffs.