Skip to Main Content
Employment

AmeriHealth Caritas Services, LLC

Court File No. 2:21-cv-05258 (Eastern District of Pennsylvania)
Wood et al. v. AmeriHealth Caritas Services, LLC

On November 30, 2021, an AmeriHealth Caritas Services, LLC (“AmeriHealth”) 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, a Clinical Care Reviewer, brings her claims on behalf of herself and other Clinical Care Reviewers (also known as Concurrent Review and Prior Authorization Nurses), who worked for AmeriHealth Caritas across the country. In the Complaint, the Plaintiff alleges that AmeriHealth Caritas misclassified her and other Clinical Care Reviewers as exempt employees, denying them overtime compensation. Plaintiff brings her overtime claims as a collective action under the federal Fair Labor Standards Act and as a class action under Pennsylvania state wage and hour law. She seeks to recover unpaid overtime compensation, liquidated (double) damages, and other statutorily-permitted relief for herself and others. According to the Complaint, Clinical Care Reviewers do not satisfy any of the overtime exemptions under federal or state law.

Type of Case

Unpaid Overtime

Share

Am I eligible?

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

Do I Have a Qualifying Federal Law Claim?

You may be eligible to make a claim under federal law if you worked over forty (40) hours per week for AmeriHealth within the past three years as a Clinical Care Reviewer, Concurrent Review Nurse, Prior Authorization Nurse, or in a similar position, and you were paid a salary.

Do I Have a Qualifying State Law Claim?

You may be eligible to make a claim under state law if you worked over forty (40) hours per week for AmeriHealth as a Clinical Care Reviewer, Concurrent Review Nurse, Prior Authorization Nurse, or in a similar position, in Pennsylvania and you were paid a salary.

Additional Information

Is This a Class Action? What Does that Mean?

This case is both a potential collective action under federal law and a potential class action under Pennsylvania state 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.

Although 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 similarly situated people who have similar claims. To proceed as a group though, the Court must certify the class and/or 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 time asking the Court to grant these certifications.

How Do I Join This Case?

To join others in making a claim for overtime compensation under federal law, you must complete a Plaintiff Consent form.  This form will be filed with the Court. To complete and submit the form electronically, click here.

What Time Frame Does This Case Cover?

There is a time limit under the federal law called a statute of limitations that allows an employee to recover unpaid wages for hours worked within two years of joining by filing a consent form. If we can prove AmeriHealth willfully violated the law, the statute of limitations may be extended to three years.

Do I Have to Pay Anything?

No, you will not have to pay us anything out of your own pocket.  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 an award, and that payment will only come out of that settlement or award. 

How Do I Prove the Overtime Hours I Worked?

If you have records relating to your work with AmeriHealth, please keep them until we ask you for them.  However, you do not need to have records of your work hours to make a claim. If AmeriHealth 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 has of your hours worked. Please ensure you do not destroy any documents or data you have that relate in any way to your work for AmeriHealth.

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. If you work for AmeriHealth and you believe you may be the victim of retaliation for joining this lawsuit, contact the case clerk, Madeline Orozco, at (612) 256-3297 or morozco@nka.com to determine whether they may be eligible to make a claim.

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?

If you know of any Clinical Care Reviewers, Concurrent Review Nurses, Prior Authorization Nurses, or others that worked in a similar position who may be interested in making a claim for unpaid overtime, please inform them that they should contact the case clerk, Madeline Orozco, at (612) 256-3297 or morozco@nka.com com to determine whether they may be eligible to make a claim.

How Do I Learn More?

To learn more about this case, feel free to contact the case clerk, contact the case clerk, Madeline Orozco, at (612) 256-3297 or morozco@nka.com to determine whether they may be eligible to make a claim.

Case Updates

  • April 18, 2022

    AmeriHealth Caritas Services, LLC Update

    On March 24, 2022, the Court conditionally certified a Fair Labor Standards Act collective of clinical care reviewers who worked for AmeriHealth Caritas from three years prior to the filing of the Complaint to the present and who have not been paid overtime for work in excess of forty hours per week. Last Friday, April 15, 2022, our office sent court-approved notice of the lawsuit to all eligible individuals who have not already joined. Eligible individuals have until May 31, 2022 to join the case.

The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. Read full Disclaimer.