Facts

On December 30, 2016, Manuel I. Figueroa, M.D., on behalf of himself and other persons similarly situated, brought a class action lawsuit against Molina Healthcare of California. The class included all California medical providers qualified to received Enhanced Payments under Section 1202 of the Affordable Care Act for eligible evaluation and management services provided to Molina Healthcare's health plan members between January 1, 2013, and December 31, 2014, who submitted claims or encounters for such services to Molina Healthcare, which claims or encounters were not denied prior to the filing of the lawsuit, and who Molina Healthcare's records indicate did not receive Enhanced Payments from Molina Healthcare for sole or all of the claims or encounters. According to Molina Healthcare's records, there were 3,464 providers in the settlement class. On June 4, 2018, the parties participated in a mediation session with the Honorable Carl J. West (retired).

PLAINTIFF'S CONTENTIONS: Plaintiff alleged that defendant failed to make enhanced payments to qualified medical providers for certain Medicaid primary care evaluation and management services and vaccinations provided between January 1, 2013, and December 13, 2014, in violation of the Patient Protection and Affordable Care Act.

DEFENDANT'S CONTENTIONS: Defendant denied all contentions.

Result

Molina Healthcare of California agreed to pay $3,488,489.53 to settle the claims.