The Nemours Foundation, which owns the Alfred I. du Pont Hospital for Children in Wilmington, Delaware, filed a federal lawsuit against United Healthcare of Delaware Monday in a dispute over pediatric care covered by Medicaid, the SF Gate reported. Nemours is suing for $15 million in damages for breach of contract and unjust enrichment after United terminated an agreement for its members to receive in-network coverage at du Pont Hospital and other Nemours facilities last year.
Nemours said that, under the agreement and state law, it was required to continue treating United patients under certain conditions and for certain periods of time even after termination of the agreement. But Nemours claimed the Medicaid rate it received from United was not paid in full for providing necessary services to United members covered under Medicaid and Delaware Healthy Children Program. United stated that Nemours is looking for payment up to 50 percent more than other children's hospitals in the region. "Nemours is now using litigation to respond to our refusal of their excessively high rates," said United spokeswoman Alice Ferreira. Article