Blue Cross Blue Shield Sued by Rural Oklahoma Hospitals

November 1, 2017

Several rural hospitals have filed a breach-of-contract lawsuit against Blue Cross Blue Shield of Oklahoma, alleging the insurance company plans to slash provider reimbursement rates.

The lawsuit alleges that the four hospitals met with the insurance provider on Oct. 3 to discuss their contracts, but that the company ignored follow up messages. One hospital alleges the company’s proposed reimbursement rates would be cut by 30 percent for all services except those delivered in an emergency room, The Oklahoman reported.

BCBS, which holds the greatest share of Oklahoma’s insurance market, has not publicly confirmed the rate proposals. The company declined to comment on the lawsuit.

The lawsuit was filed on behalf of the hospitals in Prague, Fairfax, Haskell and Drumright. It alleges that, “BCBS, through its actions and behavior, is attempting to drive critical access hospitals out of business in favor of driving business to large metropolitan hospitals and related services.”

Randy Simmons, CEO of Prague Community Hospital, said the proposed rates wouldn’t allow his hospital to continue serving BCBS patients.

The four hospitals successfully sought a temporary restraining order that prevented their contracts from expiring Sunday. A hearing in the case is scheduled later this week.

“We want to make sure all the parties comply with the provider agreement, and these hospitals get a fair opportunity to enter into negotiations with BCBS as set forth in the agreement,” said Peter Brolick, attorney for the hospitals.

Topics Lawsuits Oklahoma

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