West Virginia Physician Sues Health Plan Over Neglected Payments

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Wheeling (W.Va.) Hospital’s suit against The Health Plan of the Upper Ohio Valley, based in Morgantown, W.Va., has been delayed in court, but a physician took the matter into his own hands and successfully recouped the money the payor owed him, according to a Wheeling News-Register report.

Thomas Wack, MD, filed suit in Marshall County Court, where a judge deemed The Health Plan was responsible for paying Dr. Wack an amount estimated to be more than $3,000 in healthcare claims for services he had performed.

Wheeling Hospital’s lawsuit against The Health Plan also named Ohio Valley Health Services, Ohio Valley Medical Center and East Ohio Regional Hospital. Wheeling claimed the parties owed the hospital $4.8 million. Wheeling also claimed OV Health neglected to fund The Health Plan because of financial difficulties. The Health Plan said it was unable to pay Wheeling due to the lack of payment from OV Health.

The judge who ruled in Dr. Wack’s favor said OV Health’s financial distress should not be a factor in The Health Plan’s reimbursement. “Regardless of whether OV is paying [The Health Plan], they have to pay physicians no matter what,” Judge Mark A. Karl said, according to the report.

Wheeling Hospital’s class-action suit, which involves nearly 200 physicians, has been delayed in federal court and there is no “time table for a resolution,” according to the report.

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