Illinois hospital gets new trial in $20M Humana dispute

Palos Community Hospital will get a new trial in a lawsuit that accuses Humana of underpaying the Palos Heights, Ill.-based hospital, according to Reuters.  

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In a May 20 opinion, the Illinois Supreme Court ruled that the hospital is entitled to a new trial because a lower court wrongly rejected its request to switch judges. Under Illinois law, parties in civil cases can substitute a judge one time.

The lawsuit stems from a 1985 contract between Michael Reese Health Plan, which Humana later acquired, and Palos Community. The hospital had another agreement with Humana subsidiary ChoiceCare, and, under that agreement, Humana would reimburse the hospital at higher rates than the Michael Reese one. Despite the different terms, the hospital alleged in 2013 that Humana kept paying the lower rates outlined in the Michael Reese contract.

In 2017, a judge denied Palos Community’s bid to change judges in the case. A jury later sided with Humana in 2018. The hospital appealed the verdict, but it was upheld in 2020. However, the state Supreme Court’s May 20 decision voids orders in the case since April 2017, according to the report.

Humana and the insurer’s attorney did not immediately respond to Reuters‘ request for comment.

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