Becker’s reported on two developments in spine lawsuits since March 19.
1. Elevance Health settled a class-action lawsuit over denial of coverage for minimally invasive sacroiliac joint fusion surgery. The settlement includes more than $2.5 million for out-of-pocket payments made for denied spine surgeries and attorney’s fees up to $825,000. The settlement stems from a 2019 lawsuit that alleged Elevance and its affiliates improperly denied coverage for the procedure, labeling it as investigational and not medically necessary, according to a legal declaration. The lawsuit claimed the denials violated the Employee Retirement Income Security Act.2. Tacoma, Wash.-based MultiCare Health’s motion to dismiss a whistleblower lawsuit over alleged unnecessary spine surgeries was denied. The health system sought to dismiss the lawsuit, which alleges it fraudulently billed federal healthcare programs for spine surgeries performed by Jason Dreyer, DO, at Deaconess Hospital in Spokane.
