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AmeriHealth Caritas, LLC

Wood v. AmeriHealth Caritas Services, LLC Court File No. 3:14-cv-01698-RNC (D. Conn.)

On August 15, 2017, we filed a lawsuit on behalf of Clinical Care Reviewers and others in a similar position against AmeriHealth Caritas Services, LLC. The Complaint alleges that AmeriHealth Caritas misclassified Clinical Care Reviewers (also known as concurrent review or prior authorization nurses) and similar positions as exempt from the overtime requirements under the federal Fair Labor Standards Act (FLSA) and Pennsylvania state law. According to the Complaint, AmeriHealth Caritas improperly failed to pay overtime wages to Plaintiff and the other similarly situated nurses when they worked more than 40 hours in a workweek. The Complaint alleges that Plaintiff and the other Clinical Care Reviewers do not satisfy any of the exemptions under the FLSA and state law. Plaintiff seeks to recover unpaid overtime compensation, liquidated damages, and other statutorily-permitted relief for herself and the putative FLSA collective and state law class.

Type of Case

Unpaid Overtime Wages

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Case Updates

  • October 8, 2018

    AmeriHealth Caritas, LLC Update

    On August 8th, the notice period to join our lawsuit against AmeriHealth Caritas ended. At the final count, 102 current and former Clinical Care Reviewers joined this collective group action. Since the closure of the notice period, we have been interviewing Clinical Care Reviewers about their time at AmeriHealth Caritas. A mediation between our attorneys and AmeriHealth’s attorneys is set for November 12th, 2018. Mediation is an opportunity to discuss and negotiate a settlement of the case prior to going to trial. If you have questions, please contact case clerk Louis Hunter at lhunter@nka.com or call directly at (612) 256-3224.​

  • July 16, 2018

    AmeriHealth Caritas, LLC– Unpaid Overtime Lawsuit - Update July 16, 2018

    On May 15, 2018, the court granted our motion for conditional certification allowing Plaintiffs to proceed as a collective group action, requiring AmeriHealth to provide a list of potential collective members, and allowing Plaintiffs to send a court-authorized notice of this lawsuit to other similarly situated Clinical Care Reviewers. On June 7, 2018, we distributed the Judicial Notice to Clinical Care Reviewers nationwide. The notice period allows Clinical Care Reviewers to join our case until August 6, 2018, and so far we have over 68current and former Clinical Care Reviewers in the case. If you have questions about the case, please contact case clerk Louis Hunter at lhunter@nka.com or call directly at (612) 256-3224.

  • December 14, 2017

    AmeriHealth Caritas, LLC– Unpaid Overtime Lawsuit - Update December 14, 2017

    On November 1, 2017, we filed a motion for Conditional Certification requesting that the court allow Plaintiffs to proceed as a collective and permit Plaintiffs to send court-authorized notice of this lawsuit to potential collective members. AmeriHealth opposed our Motion on December 1, 2017, and we replied on December 8, 2017. The Court is in the process of reviewing this Motion, and we await its decision. In the meantime, this case is proceeding through the discovery phase of litigation, which is the formal exchange of information between the parties.

  • August 18, 2017

    Clinical Care Reviewers Represented by Nichols Kaster, PLLP Files Collective Action Overtime Lawsuit Against AmeriHealth Caritas Services, LLC

    On August 15, 2017, an AmeriHealth Caritas Services, LLC employee filed a lawsuit in the United States District Court for the Eastern District of Pennsylvania to recover unpaid overtime wages from her employer. AmeriHealth Caritas is a multi-line health insurance company that provides managed care programs and related services.

    The Plaintiff brings her claims on behalf of herself and other Clinical Care Reviewers (also known as concurrent review and prior authorization nurses) and similar positions) who worked for AmeriHealth Caritas across the country. In the Complaint, the Plaintiff alleges that AmeriHealth Caritas misclassified her and other utilization review nurses as exempt employees, denying them overtime compensation. Plaintiff brings her overtime claims under the federal Fair Labor Standards Act and under Pennsylvania state wage and hour law. According to the Complaint, Clinical Care Reviewers do not satisfy any of the exemptions under federal or state law.

    Plaintiff's attorney Rachhana T. Srey of Nichols Kaster, PLLP explains, "I have represented many nurses over the years whose primary job it is to do utilization review work. They deserve to be paid overtime compensation for the long hours they are required to work in order to meet the company's expectations and standards."

    Plaintiffs are represented by Rachhana T. Srey and Paige C. Fishman of Nichols Kaster, PLLP. The case is entitled, Wood v. AmeriHealth Caritas Services, LLC, 3:14-cv-01698-RNC (Eastern District of Pennsylvania).

    Additional information about how Clinical Care Reviewers may make a claim in the case may be found at www.nka.com or by calling Nichols Kaster, PLLP toll free at (877) 448-0492.

Am I eligible?

Because this lawsuit arises under both state and federal law, you may have a qualifying state law claim, federal law claim, or both state and federal law claims.

Do I Have a Qualifying State Law Claim?

You may have a claim under Pennsylvania state law if you worked for AmeriHealth Caritas as a Clinical Care Reviewer (also known as prior authorization or concurrent review nurses) or as an employee performing similar job duties in the State of Pennsylvania at any time during the last three years and were not paid overtime wages when you worked more than 40 hours in a workweek.

Do I Have a Qualifying Federal Law Claim?

You are eligible to make a federal law claim in this case if you worked for AmeriHealth Caritas at any time within the past three years in any state and were not paid overtime wages when you worked more than 40 hours in a workweek.

Additional Information

Is This a Class Action? What Does that Mean?

This case is both a potential class action under state law and a potential collective action under federal law. This means that, depending on the type of claim you have, there may be a slightly different process for joining and participating in this suit. See below for more details on this process.

Though the process and terminology may differ slightly, the idea behind both a class and collective action is the same: it allows one or more people to sue on behalf of themselves and other people who have similar claims. In order to proceed as a group, though, the Court must certify the class and collective. Because we are in the early stages of the case, this has not happened yet, but we intend to seek the company’s agreement or file the motions at the appropriate times asking the Court to grant these certifications.

Which Locations Are Included?

This case includes Clinical Care Reviewers and employees performing similar job duties for AmeriHealth Caritas anywhere across the country including working from home.

What Time Frame Does This Case Cover?

There is a federal time limit, called a statute of limitations, that allows an employee to recover unpaid wages for overtime hours worked within two years of the employee signing up to join the lawsuit by completing the consent form referenced above. If we can prove that AmeriHealth Caritas willfully violated the law, the statute of limitations may be extended to three years.

Do I Have To Pay Anything?

You do not have to pay anything to our firm if you join the lawsuit. We are handling this case on a contingency basis. This means we will only be paid if the lawsuit is successful in obtaining relief either through a settlement or a final judgment, and that payment will only come out of that settlement or final judgment.

How Do I Prove I Worked Overtime?

If you do have records, please preserve and keep them until we ask you for them, but you do not need to have records of your work hours to participate in this case. If AmeriHealth Caritas did not keep accurate time records, most courts will permit you to make a “good faith estimate” of your work hours. We will seek any records the company may have of your hours worked through this lawsuit.

What About Retaliation?

It is against the law for an employer to retaliate against a person for joining a lawsuit to reclaim unpaid wages. If you suffer retaliation, you may have additional claims against your employer. If you currently work for AmeriHealth Caritas and you believe you may be the victim of retaliation for joining or participating in this lawsuit, contact us immediately.

How Long Will This Case Take?

The length of this kind of lawsuit varies from case to case, but they typically last one to three years.

Is There Money Available Now?

No. This is a pending lawsuit. There is no money currently available and there is no guarantee that you will receive money for participating in the lawsuit.

How Can I Help?

Right now, we are hoping to talk to as many AmeriHealth Caritas Clinical Care Reviewers or other similar employees as possible to learn more about the claims. If you have information regarding Clinical Care Reviewers at AmeriHealth Caritas, you can contact the case clerk, Louis Hunter at lhunter@nka.com or call directly at (612) 256-3224.

How Do I Learn More?

To learn more about this case, feel free to contact the case clerk, Louis Hunter at lhunter@nka.com or call directly at (612) 256-3224.

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