Benefits & Executive Compensation News

Blue Cross Texas Beats, for Now, Suit Over Emergency Services

Dec. 4, 2018, 6:29 PM

Blue Cross Blue Shield of Texas defeated, at least for now, a lawsuit by 49 physician groups that accuse the insurer of underpaying more than 250,000 claims for reimbursement for emergency medical services.

A federal judge dismissed the case Dec. 3 in a two-page order that didn’t explain the decision.

The physician groups though have 60 days to file a new complaint with additional facts supporting their claims.

Blue Cross is accused of setting the amounts it reimburses out-of-network providers so low they violate Texas insurance laws and regulations.

Those practices have drawn the attention of the Texas Department of Insurance, which in 2008 found the insurer in violation of state law, the physician groups say.

Judge Karen Gren Scholer of the U.S. District Court for the Northern District of Texas issued the order.

King & Spalding LLP and Winstead PC represent the physician groups. Kirkland & Ellis LLP and Hedrick Kring PLLC represent the insurer.

The case is Angelina Emergency Medicine Assocs. PA v. Blue Cross Blue Shield of Tex., N.D. Tex., 12/3/18.

To contact the reporter on this story: Jacklyn Wille in Washington at jwille@bloomberglaw.com

To contact the editors responsible for this story: Jo-el J. Meyer at jmeyer@bloomberglaw.com; Steven Patrick at spatrick@bloomberglaw.com

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