A Chicago dentist and his practice filed a defamation lawsuit Feb. 4 against insurance company Humana.
The lawsuit was filed by James Orrington II, DDS, of Chatham Dental Care in Chicago.
According to the lawsuit, Chatham Dental Care was formerly in network with Humana and included on the insurer's list of approved practices.
In 2019, Humana allegedly denied coverage of treatment performed on a patient unless a more invasive procedure was performed. Dr. Orrington allegedly told Humana such recommendations by a third-party insurer were improper but agreed to perform the procedure because of the insurer's financial leverage.
Humana allegedly called Dr. Orrington and criticized his practice's scaling and root planning procedures. Dr. Orrington said the number of those procedures performed was necessary because his patients lived in an area where a lack of food options affected their dental health.
Humana allegedly later notified Dr. Orrington that his practice was removed from the insurer's list without cause. In 2020, Humana allegedly filed a complaint with the Illinois Department of Financial and Professional Regulation regarding practices at the dental clinic. The insurer then allegedly denied Dr. Orrington a copy of the complaint. A hearing before the regulatory organization was held in June 2021 and no further action was taken.
Dr. Orrington claims Humana's actions led to his practice being dropped by his professional liability carrier, higher premiums for its replacement insurance coverage and forcing it to retain counsel as a result of the IDPFR complaint. The lawsuit claims Humana's actions were motivated by its desire to cause financial and reputational injury to the practice.
Becker's has contacted Humana for comment and will update this story as more information becomes available.