Johns Hopkins demands $2M from MD health plan

Making an emphatic move in a disagreement that has simmered for more than five years, Johns Hopkins Healthcare has sued regional Blue plan CareFirst of Maryland for $2 million, claiming that it owes that sum for claims made since October 2004. Johns Hopkins says that CareFirst, the region's largest health plan, denied or underpaid for nearly 15,000 claims for service performed through April 30. It also claims that CareFirst cut some already-negotiated Medicare reimbursement rates without disclosing those changes, as well as using outdated fee schedules and making mathematical mistakes.

This is not the first time Hopkins has made such a charge against CareFirst. Back in 2003, Hopkins attorneys sued CareFirst for more than $250,000 for nonpayment of services, arguing that the plan had underpaid it for services delivered at the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center.

Hopkins is asking the Circuit Court of Baltimore County to address these issues, as well as determine whether CareFirst is the primary payer for members also covered by Medicare or other federally funded health plans.

To learn more about the dispute:
- read this FierceHealthcare piece

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