Georgia surgery centers have filed a federal court suit against a Georgia health carrier.
The surgery centers allege that Blue Cross Blue Shield of Georgia, Atlanta, a unit of WellPoint Inc., Indianapolis, has been paying centers only a fraction of the actual cost of procedures when Georgia Blue plan members go to the centers for out-of-network care.
The plaintiffs, represented by Butler, Wooten, and Fryhofer, Atlanta, and J. Tom Morgan of Decatur, Ga., say members of the Georgia Blue health plan paid a higher premium to get coverage for out-of-network care.
Georgia Blue imposed immoderate reimbursement cuts on out-of-network providers, reducing payments to only a small portion of the centers’ normal charges, the plaintiffs allege.
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According to the suit, Georgia Blue’s actions violate the company’s own contracts as well as federal and state patient protection laws.