Attorneys for Knox County Hospital in Texas say that the state’s recent $10 million fine levied against Blue Cross Blue Shield (BCBS) demonstrates the need for a much broader review of the insurer.
The Texas Department of Insurance (TDI) announced Friday that BCBS had agreed to pay the fine, as well as restitution to customers, for mishandling out-of-network emergency claims and providing incorrect information to consumers. BCBS agreed to pay the fine within 30 days and complete restitution payments by the end of the year.
According to attorneys for Knox County Hospital, BCBS stopped making reimbursement payments to the hospital in June 2017. The insurer did not respond to the hospital’s inquiries until October 2017, when it claimed that the cessation of payments was due to a computer glitch. Knox County Hospital continued to treat BCBS patients and submit claims, but BCBS continued to withhold reimbursement.