Elevance Health has filed a lawsuit accusing Perfect Child, an autism therapy provider, of defrauding the insurer out of an estimated $160 million. The core of the allegations centers on Perfect Child’s alleged use of multiple limited liability companies (LLCs) to disguise its out-of-network billing practices. Elevance Health contends that Perfect Child intentionally routed claims through these various entities to charge significantly higher out-of-network rates, thereby inflating costs and misleading the insurer about the true nature of the services provided and their associated expenses. This intricate billing structure, according to the lawsuit, was designed to circumvent in-network agreements and maximize financial gain at the expense of the insurer and potentially its policyholders.
Adapted from: WSJ.com: Markets
