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T. Christian Miller @txtianmiller
https://x.com/txtianmiller/status/1911453634942107883
https://threadreaderapp.com/thread/1911453634942107883.html
In September, a Louisiana jury awarded $421M to a hospital specializing in breast restorations for women with cancer-related mastectomies. Blue Cross, jurors found, committed fraud.
https://www.documentcloud.org/documents/25892343-2024-09-27-jury-form-with-verdict/?mode=document
Meet Witney Arch, a 42-year-old mom of four. When she found out she had breast cancer, she decided to go to the Center for Restorative Breast Surgery in New Orleans, renowned for its highly specialized approach to post mastectomy breast reconstruction.
Blue Cross gave her prior authorization. Then things got strange. A little before the operation, a representative called to try to convince her to go somewhere else: “Do you know how much this is going to cost?”
Witney wasn’t the only patient who got pushback. Founding surgeons Frank DellaCroce and Scott Sullivan had battled
@MyLouisianaBlue in court for 18 years over payments for surgery that Blue Cross agreed was medically necessary.
The crux of the case: Blue Cross had approved more than 7,800 procedures related to mastectomies and breast restorations. But it paid only about 9% of the bills for those treatments. And sometimes nothing at all. In fact, 60% of the claims were zero pay.
The center argued this was a promise made, but not paid and thus, fraud. Its attorney said Blue Cross’ policy was “Slow Pay, Low Pay or No Pay” https://www.propublica.org/article/blue-cross-blue-shield-louisiana-insurance-lawsuit-breast-cancer-doctors
In September, a Louisiana jury awarded $421M to a hospital specializing in breast restorations for women with cancer-related mastectomies. Blue Cross, jurors found, committed fraud.
https://www.documentcloud.org/documents/25892343-2024-09-27-jury-form-with-verdict/?mode=document
Blue Cross’ Business model is to keep your money and let you die for their profit.
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