Blue Cross Georgia Sues Surprise Billing ‘Expert’ for Fraud (1)

Software platform HaloMD, Inc. submitted ineligible claims for arbitration under a federal law meant to shield patients from surprise medical bills to win “outrageous payment offers” and fees totaling nearly $6 million from insurers, according to a complaint from Blue Cross Blue Shield of Georgia.

The case highlights another aspect of the rocky rollout of the No Surprises Act, which requires insurers and doctors to settle via arbitration most unexpected out-of-network disputes instead of billing the patient directly. Doctors have accused insurance companies of not paying their bills when they lose, while insurance companies say doctors are making mistakes and ...