SpecialtyCare sues Anthem over $2.5 million in unpaid awards - InsuranceNewsNet - 九游APP
A Virginia federal lawsuit seeks enforcement of 1,443 payment determinations obtained by SpecialtyCare and affiliated physician groups. SpecialtyCare Inc. and two affiliated physician groups are suing two Anthem health plans in Virginia, alleging the insurers failed to pay roughly $2.5 million owed under federal decisions resolving out-of-network medical payment disputes. The lawsuit, filed Oct. 16 in the U.S. District Court for the Eastern District of Virginia, names Anthem Health Plans of Virginia Inc. and HealthKeepers Inc. as defendants. According to the complaint, the providers obtained 1,443 awards through the No Surprises Act's independent dispute resolution process. The No Surprises Act protects patients from certain unexpected out-of-network medical bills and establishes a process for providers and insurers to resolve payment disputes over covered services. The lawsuit includes claims seeking to confirm and enforce the payment awards under both the No Surprises Act and the Federal Arbitration Act. It also includes claims under the Employee Retirement Income Security Act involving certain employer-sponsored health plans.
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