S.F. City Attorney Sues Insurers for Allegedly Underpaying Hospitals
On Wednesday, San Francisco City Attorney Dennis Herrera (D) announced that he is suing three large health insurers for allegedly underpaying San Francisco General Hospital and other public hospitals for emergency services, the San Francisco Examiner reports.
Herrera filed the lawsuit in San Francisco Superior Court against Anthem Blue Cross Life and Health Insurance, Blue Cross of California and Health Net (Burack, San Francisco Examiner, 5/25).
According to the lawsuit, the health insurers have refused to fully reimburse public hospitals for emergency services. Instead, the lawsuit claims, the insurers are applying arbitrary reductions to the bills they receive.
Herrera said the underpayments jeopardize San Francisco's "ability to provide critically necessary emergency health care."
The lawsuit is seeking an injunction to stop what Herrera's office called unfair business practices. The suit also is pursuing reimbursement for the alleged underpayments and civil penalties as high as $2,500 for each violation of the state's business code.
Peggy Hinz, spokesperson for Anthem Blue Cross, said, "Based on what we understand the allegations to be, we dispute the city attorney's claim that Anthem has 'illegally' been paying less than the full billed charges of the hospital." Hinz added, "Once we have an opportunity to review the suit, we intend to vigorously defend our practices."
Amy Sheyer, spokesperson for Health Net, said her company is reviewing the lawsuit but could not comment on pending litigation (McMenamin, Bay City News/San Francisco Appeal, 5/25).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.