Blue Cross Blue Shield of North Carolina is seeking sanctions against LifeBrite Community Hospital of Stokes (N.C.) in a longstanding legal dispute that centers around allegations of fraudulent billing practices.
The dispute began in 2018 when LifeBrite accused BCBSNC of withholding at least $15.5 million in reimbursements for services it provided to members. In its counterclaim, BCBS alleged that LifeBrite engaged in deceptive practices by submitting fraudulent claims for laboratory services, specifically urine toxicology tests, that were never performed. BCBS claims that the hospital, through its affiliated laboratory, billed for tests that were conducted outside of its network and misrepresented them as services provided by the hospital itself. BCBS also alleged that LifeBrite’s actions amounted to fraud and caused significant financial damage to the insurer.
BCBS claims that LifeBrite’s billing practices resulted in over $76 million in false claims, with the hospital receiving over $11 million in improper payments. The payer is seeking restitution and punitive damages, along with an injunction to prevent further fraudulent actions.
The case has seen numerous legal motions and hearings, including motions to dismiss and discovery disputes. In its most recent filings in April, BCBS accused LifeBrite of using “cat-and-mouse” tactics during the discovery process, claiming the hospital has been evasive and misleading when responding to requests for information. BCBS has asked the U.S. District Court for the Middle District of North Carolina to impose sanctions over the alleged tactics and to prevent LifeBrite from presenting certain evidence at trial.
