Mayo Clinic and its health plan administrator Medica "systemically underpaid" claims and left employees with large healthcare bills, according to a proposed class action lawsuit filed by a Mayo Clinic Arizona employee.
The lawsuit filed April 2 alleges that the Rochester, Minn.-based health system and its employee health plan violated ERISA and their fiduciary duties by using pricing methods that are "deceptive, misleading, arbitrary, illusory, unpredictable, and allow for inconsistent reimbursements."
According to the suit, Mayo and Medica did not provide accurate or complete information through the employee benefits portal, including how they calculate out-of-network reimbursement costs and deductibles. The Mayo employee also alleges the portal did not provide accurate information about which providers were in-network, and that some providers were listed as being in-network when they were not.
The plaintiff is seeking the recovery of funds that are allegedly owed or that were overpaid for care that should have been reimbursed, along with class action status on behalf of Mayo Clinic employees.
"Mayo Clinic is committed to supporting the health and wellness of our employees and their families," a Mayo spokesperson told Becker's. "Our benefits plan is designed to provide flexibility to help our employees meet their healthcare needs. As the lawsuit has just been filed and we are in the process of reviewing the claims, we will not comment further at this time."
Medica told Becker's it does not comment on pending litigation.