Case research · Sources checked October 12, 2026
Cigna "PxDx" algorithmic claim-denial class action (Kisting-Leung)
Plaintiffs, Cigna health plan members, allege that Cigna used an automated algorithm called PxDx to deny payment requests in batches of hundreds or thousands at a time when a treatment did not match pre-set criteria, and that Cigna medical directors signed off on denials in seconds without individualized review. The complaint claims each plaintiff's claim was reviewed and denied through PxDx, that Cigna did not disclose PxDx's role in many adverse determinations, and that this conflicts with plan terms promising medical-necessity review by a medical director.
Every line on this page is checked against the court docket and the regulators involved. We do not decide whether you are part of this case or match you with a lawyer. What we do is help you get the medical records that matter, from any provider.
- Status
- Active
- Court
- U.S. District Court for the Eastern District of California (Sacramento)
- Docket
- 2:23-cv-01477-DAD-CSK
- Judge
- Hon. Dale A. Drozd (District Judge)
- Started
- July 24, 2023
- Defendants
- The Cigna Group (formerly Cigna Corporation), Cigna Health and Life Insurance Company
Where it stands
As of October 12, 2026
After the March 31, 2025 order dismissing the ERISA benefits claim with leave to amend and narrowing the remaining claims, plaintiffs elected not to amend and Cigna answered the Third Amended Complaint on May 2, 2025. The case is in discovery with two remaining named plaintiffs (Dababneh and Rentsch). An August 24, 2026 joint stipulation (Doc. 97) seeks to extend fact depositions to October 15, 2026, set the class certification motion for October 29, 2026, complete expert discovery by April 14, 2027 and file all motions by May 17, 2027; the existing scheduling order (Doc. 60) sets a final pretrial conference for September 27, 2027 and trial for November 30, 2027. Court approval of the stipulation was not verified.[5]
The complaint
What is alleged, and what is not decided
Plaintiffs, Cigna health plan members, allege that Cigna used an automated algorithm called PxDx to deny payment requests in batches of hundreds or thousands at a time when a treatment did not match pre-set criteria, and that Cigna medical directors signed off on denials in seconds without individualized review. The complaint claims each plaintiff's claim was reviewed and denied through PxDx, that Cigna did not disclose PxDx's role in many adverse determinations, and that this conflicts with plan terms promising medical-necessity review by a medical director. Cigna describes PxDx as a process designed to speed approval of covered services and route unmatched claims to medical directors, and disputes the allegations. The surviving claims are an ERISA fiduciary-breach claim under 29 U.S.C. 1132(a)(3) and a California Unfair Competition Law claim, now pursued by two named plaintiffs.
Timeline
How the case has moved
Original class action complaint filed (Doc. 1).[1]
Third Amended Complaint filed by stipulation (Doc. 36), asserting ERISA 502(a)(1)(B), ERISA 502(a)(3) and California UCL claims.[1]
Cigna moves to dismiss the Third Amended Complaint (Doc. 46).[2]
Order granting in part and denying in part the motion to dismiss (Doc. 55, signed March 30): ERISA 502(a)(1)(B) benefits claim dismissed with leave to amend for failure to identify the plan terms entitling plaintiffs to benefits; ERISA 502(a)(3) and UCL claims dismissed as to some plaintiffs for lack of standing/timeliness but proceed as to Dababneh and Abbas (and Rentsch on the fiduciary claim); UCL claim held not expressly preempted by ERISA.[1]
Cigna answers the Third Amended Complaint after plaintiffs file notice they will proceed on the surviving claims rather than amend.[3]
Joint scheduling report (Doc. 58) proposes fact discovery close of May 1, 2026 and class certification motion by August 22, 2026; notes coordination with the related Snyder v. Cigna case in the District of Connecticut.[4]
Joint stipulation (Doc. 97) to extend deadlines: remaining Cigna corporate-representative deposition by Oct. 15, 2026; class certification motion Oct. 29, 2026; opposition Jan. 11, 2027; reply Mar. 15, 2027; expert discovery complete Apr. 14, 2027; all motions by May 17, 2027. Recites existing trial date of Nov. 30, 2027 (Doc. 60).[5]
If this involves you
The records that matter, and who has them.
Whatever you decide to do next, you will be asked for these. They are yours by law, and most providers have up to 30 days to send them once they have your signed request.
Adverse benefit determination (denial) letters and Explanation of Benefits statements showing the denial reason and remark/denial codes
Identify which claims were denied, on what stated basis, and whether any reference is made to the review process; the complaint alleges PxDx's role was often not disclosed.
Held by: Cigna (member portal or written request); the billing provider's office
The governing plan document and Summary Plan Description (for employer ERISA plans) or policy/Evidence of Coverage (for individual plans)
The court dismissed the ERISA benefits claim because plaintiffs did not identify the plan terms entitling them to benefits; the plan's medical-necessity and medical-director review language is central.
Held by: Employer or plan administrator (ERISA plans must furnish on written request); Cigna for individual policies
The complete claim file, including internal clinical review notes and the identity and credentials of the reviewer
ERISA claims regulations entitle claimants to copies of documents relevant to a denied claim on request; this is where any automated-review record would appear.
Held by: Cigna (claims/appeals department), on written request
Treating clinician's orders, visit notes and letters of medical necessity for the denied service
Documents the clinical basis for the service that plaintiffs allege was denied without individualized review.
Held by: The treating physician, lab, imaging center or hospital
Appeal correspondence: internal appeal submissions and decisions, and any external/independent medical review decision
Shows whether the denial was challenged, what was submitted, and the outcome and dates (relevant to timeliness).
Held by: Cigna; state independent review organization or California Department of Managed Health Care / Department of Insurance if external review was used
Provider itemized bills and proof of payment for denied services
Establishes what the patient paid or owes as a result of the denial.
Held by: The provider's billing office; the patient's own payment records
We send the request, follow up with the provider, and deliver the records to you. We don't take case details here and we never share your records with a law firm unless you tell us to.
Questions people ask
Straight answers, with sources
Is the Cigna PxDx lawsuit real, and where is it pending?
Yes. Kisting-Leung v. Cigna Corp., No. 2:23-cv-01477, is a putative class action pending in the U.S. District Court for the Eastern District of California before Judge Dale A. Drozd. It was filed July 24, 2023.[1]
Was the case dismissed?
Partly. On March 31, 2025 the court dismissed the ERISA benefits claim with leave to amend and dismissed the remaining claims as to several plaintiffs, but allowed the ERISA fiduciary-breach and California Unfair Competition Law claims to proceed for the remaining plaintiffs. Plaintiffs chose not to amend and the case moved into discovery.[4]
Has a class been certified?
No. Under the parties' August 24, 2026 stipulation, plaintiffs' class certification motion would be filed October 29, 2026, with briefing into 2027. The scheduling order sets trial for November 30, 2027.[5]
What is PxDx, according to each side?
Plaintiffs allege PxDx is an algorithm that denies payment requests in batches when a procedure does not match preset diagnosis criteria, without individualized physician review. Cigna says PxDx was designed to speed approval of covered services and route unmatched claims to medical directors for review.[4]
Why did the court dismiss the ERISA benefits claim?
The court held plaintiffs had not identified the specific plan terms that entitled them to the denied benefits, and found one plaintiff's benefits claim untimely; it granted leave to amend.[1]
Sources
Where every fact on this page comes from
Primary sources only: court orders, the Judicial Panel on Multidistrict Litigation, federal regulators and state attorneys general. Each entry shows the day we opened it. This is reference material, not legal or medical advice.
- [1]Order Granting in Part and Denying in Part Defendants' Motion to Dismiss (Doc. 55)
U.S. District Court, E.D. Cal. (court order mirrored by Georgetown Health Care Litigation Tracker; also mirrored at cases.justia.com) · litigationtracker.law.georgetown.edu · opened October 12, 2026
ERISA 502(a)(1)(B) dismissed with leave to amend; 502(a)(3) and UCL proceed for some plaintiffs; UCL not preempted.
- [2]Defendants' Motion to Dismiss Third Amended Complaint (Doc. 46)
Court filing mirrored by Georgetown Health Care Litigation Tracker · litigationtracker.law.georgetown.edu · opened October 12, 2026
Cigna's motion filed Aug. 23, 2024.
- [3]Cigna's Answer to Plaintiffs' Third Amended Complaint
Court filing mirrored by Georgetown Health Care Litigation Tracker · litigationtracker.law.georgetown.edu · opened October 12, 2026
Answer filed May 2, 2025.
- [4]Joint Scheduling Report (Doc. 58)
Court filing mirrored by Georgetown Health Care Litigation Tracker · litigationtracker.law.georgetown.edu · opened October 12, 2026
Each side's description of the case; surviving claims; proposed schedule.
- [5]Joint Stipulation to Extend Deadlines (Doc. 97)
Court filing mirrored by Georgetown Health Care Litigation Tracker · litigationtracker.law.georgetown.edu · opened October 12, 2026
Proposed 2026-27 class certification and expert schedule; trial Nov. 30, 2027 per Doc. 60.
- [6]Application for Pro Hac Vice and Order (E.D. Cal. 2:23-cv-01477)
U.S. District Court, E.D. Cal., via GovInfo · govinfo.gov · opened October 12, 2026
Confirms case number, caption and defendant entities (The Cigna Group f/k/a Cigna Corporation; Cigna Health and Life Insurance Company).