The Metropolitan Government of Nashville hired HRI earlier this year to collect overpayments to physicians who saw patients on the school plan, and HRI sent letters to physicians demanding repayment for claims that dated back years in some cases and accusing physicians of coding visits at too high a level, according to the report.
The lawsuit has named, in addition to HRI, the Metropolitan Government of Nashville and Davidson County, Tenn., its board of education, which runs a self-insured health plan for school employees, and BlueCross BlueShield of Tennessee, the contracted third-party administrator for the school plan, as defendants. BCBS of Tennessee sent letters to physicians claiming they had no involvement with HRI’s collection efforts before the lawsuit.
TMA also alleges that HRI was allowed to keep 40 percent of any of the collections received from physicians, according to the report.
HRI has sent collection letters to physicians in several other states, including Georgia, Kentucky, Tennessee and Texas. Other states are watching the suit as currently self-insured plans have no statute of limitations on collecting on retrospective overpayments.
Read the AMNews’ report on the Tennessee Medical Association’s lawsuit against HRI.
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