10 recent hospital reimbursement, billing disputes

The following disputes over hospital billing, reimbursement and collections occurred in June.

1. 2 health systems sue Mississippi over alleged flaw in Medicaid reimbursement formula
Memorial Hospital and Singing River Health System in Pascagoula, Miss., filed suit against the Mississippi Division of Medicaid, claiming that there is a fundamental flaw in the Medicaid reimbursement formula Medicaid uses to pay hospitals for healthcare services.

2. UW Medicine hospital broke charity care law, class-action lawsuit claims
A class-action lawsuit alleges NorthwestHospital & MedicalCenter in Seattle fails to properly screen patients for charity care in violation of the Washington state Charity Care Act.

3. Court rejects Aetna's $225M billing suit against North Cypress Medical Center
A federal judge dismissed a lawsuit brought by insurance giant Aetna that accused North Cypress (Texas) Medical Center of fraudulent billing charges.

4. United, UNMH split on Medicaid patients, cite reimbursement issues
University of New Mexico Hospital in Albuquerque and health insurance giant UnitedHealthcare terminated a contract agreement for services provided to Medicaid patients.

5. Hackensack University Medical Group goes out of network with UnitedHealthcare
UnitedHealthcare dropped its coverage for ACA policyholders who receive medical treatment at Hackensack (N.J.) UniversityMedicalCenter, citing reimbursement disagreements.

6. Mercy files $4.1M suit against Aetna for allegedly withholding reimbursement
Chesterfield, Mo.-based Mercy filed suit against Aetna, claiming the health insurance company failed to pay the full, agreed upon amount for care provided to certain newborn babies.

7. Premier Health hospitals no longer in CareSource's Just4Me network
Dayton, Ohio-based CareSource dropped Premier Health hospitals from its Just4Me health network. The insurer instead inked an agreement with Dayton, Ohio-based Kettering Health Network, which the insurer said offered more reasonable terms in regard to cost.  

8. Couple claims Cabell Huntington Hospital illegally attempted to collect debt
A suit filed by a West Virginia couple alleges Cabell Huntington (W.Va.) Hospital violated the West Virginia Consumer Credit and Protection Act by illegally attempting to collect a debt.

9. LA hospital sues BCBS of Ga. for giving reimbursement money to patients
Los Angeles-based Martin Luther King Hospital filed suit against Blue Cross Blue Shield of Georgia, alleging the insurer sends reimbursement money for emergency room services administered at MLK directly to patients as a means of retaliation against out-of-network hospital prices.

10. Patient accuses Union County Hospital of filing erroneous debt collection suit
A former patient of Union County Hospital in Anna, Ill., countersued the hospital over an allegedly erroneous debt collection lawsuit, which she said is without merit as she was making payments under a plan both parties agreed upon.

More articles on hospital finance and legal issues: 

Feds pressure judge to drop Oregon insurer's lawsuit over risk corridor payments
Jury orders Tri-City Medical Center to pay nearly $20M for breached contract
Pacifica Hospital to pay $1M settlement for patient dumping

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