Class action lawsuit could cost a eight figure penalty to Blue Cross Georgia

Georgia surgery centers are seeking class action against Blue Cross that could cost the state’s largest health insurer tens of millions of dollars. The the suit claims that Blue Cross violate federal and state laws protecting patients and providers, as well as Blue Cross Blue Shield’s contracts.

The suit, filed against Blue Cross Blue Shield Healthcare Plan of Georgia Inc. and Blue Cross and Blue Shield of Georgia, alleges:

  • Blue Cross Georgia has discouraged visits to out-of-network providers by reimbursing procedures at a tiny fraction of “usual and customary” charges.
  • Blue Cross members paid higher premiums in exchange for the flexibility to receive coverage for care from providers who are not part of the plan’s preferred network.
  • Blue Cross Georgia has targeted these out-of-network providers, including ambulatory surgery centers, “for a drastic and unprecedented slash in reimbursement to a mere fraction of usual and customary charges.

However, Blue Cross Georgia spokeswoman Cheryl Monkhouse dismissed the allegations as being without merit and confirmed to defend the suit vigorously.

Source: Atlanta Business Chronicle

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