Legal News

Blue Cross accused of deliberately underpaying out-of-network hospitals

By Richard Binder

Methodist Hospital of Southern California has accused Blue Cross and Anthem affiliates in 10 states of RICO and ERISA violations.  Methodist alleges that Blue Cross refuses to let it transfer patients from emergency rooms, then underpays the hospital and sticks patients with hefty bills, claiming the patients "requested" to stay, although Blue Cross in reality made that decision for them.

Even though the hospital quit the Blue Cross network in 2008, Methodist is still required to treat any Blue Cross patient brought to its emergency room with life-threatening injuries. The hospital claims that in nearly every instance, Blue Cross refused to transfer the patient to an in-network hospital and then underpaid the hospital.

Blue Cross faces similar actions in courts across the country.  Methodist Hospital wants a jury trial, restitution, and unspecified damages. It is represented by Daron Tooch of Hooper, Lundy & Bookman.

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Full post as published by Legal Pad | LA on August 03, 2009 (boomark / email).