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.
According to the suit, Georgia Blue’s actions violate the company’s own contracts as well as federal and state patient protection laws.