Blue Cross and Blue Shield of Florida has been ordered to pay $1.5 million to two hospitals as compensation for hospital bills it refused to pay. A jury found that the plan's HMO inappropriately refused to reimburse the two hospitals, Miami's Palmetto General Hospital and Coral Gables Hospital, for certain hospital pathologist services. Eight years ago, the health plan's Health Options HMO stopped paying hospital pathologists for supervising and interpreting tests. In the suit, the hospitals argued that state law required the HMO to pay for all aspects of pathology services. The attorney who represented the hospitals, Ervin Gonzales, is representing 11 other hospital pathology groups across the state in similar actions.
To learn more about the case:
- read this South Florida Business Journal piece [1]
Related Articles:
Blues reach $128M settlement with MDs. Report [2]
California hospitals, MDs join Blue Cross payment suit. Report [3]
Blue Cross of CA settles plan-cancellation suits. Report [4]
Blue Cross slapped with $200,000 fine. Report [5]
Links:
[1] http://www.bizjournals.com/southflorida/stories/2007/04/30/daily28.html?b=1177905600^1456355
[2] http://www.fiercehealthcare.com/story/blues-reach-128m-settlement-with-mds/2007-04-30
[3] http://www.fiercehealthcare.com/story/calif.-hospitals-mds-join-blue-cross-payment-suit/2007-04-23
[4] http://www.fiercehealthcare.com/story/blue-cross-of-ca-settles-plan-cancellation-suits/2006-10-18
[5] http://www.fiercehealthcare.com/story/blue-cross-slapped-with-200-000-fine/2006-09-22