Memorial Hermann Health System (Memorial Hermann) filed suit against defendant Blue Cross Blue Shield of Texas on Thursday in the Southern District of Texas. The complaint claims that the defendant health insurance company was “prioritizing profits over patient well-being and its obligation to pay for emergency and subsequent care.”
The plaintiff asserts that the defendant lost hundreds of millions of dollars due to Affordable Care Act Exchange plans and individual market plans in 2013 and 2014. In an effort to make up for these losses, BCBS allegedly began a practice of “wrongly denying hundreds of valid Blue Advantage and MyBlue Health claims for emergency services and post-stabilization care,” including those that the plaintiff had filed.