Sartell, Minn.-based Center for Pain Management is challenging Blue Cross and Blue Shield of Minnesota's decision to terminate its network contract, according to the St. Cloud Times.
The payer ended its contract with the pain clinic Oct. 1 after its review of medical records and practices, and billing information. The insurer also reported the behavior to both the Minnesota Department of Commerce and the Federal Bureau of Investigation.
"Blue Cross is required to report the results of medical and billing practice reviews to multiple regulatory bodies when certain criteria are met," the payer told the St. Cloud Times.
A Center for Pain Management attorney said Blue Cross and Blue Shield of Minnesota's main two issues involved some patients seeking care at the clinic when they should have received care at a hospital, and deeming use of anesthesia during a spine pain treatment as an unnecessary expense.
However, the clinic claims that it has handled the treatments in question safely at its surgery center. It also claims patients pay less for those procedures at the surgery center compared to a hospital, according to the St. Cloud Times.
The clinic also claimed that it uses mild anesthesia during radiofrequency ablation treatment, which aims to reduce the pain experienced by inserting a needle into a patient's spine where they are already experiencing pain.
About 15 percent of Center for Pain Management patients are Blue Cross and Blue Shield of Minnesota members, according to the St. Cloud Times.