Medical University Hospital sues BlueCross BlueShield of SC for alleged nonpayment

Charleston, S.C.-based Medical University Hospital is suing BlueChoice Health Plan of South Carolina, a subsidiary of Blue Cross Blue Shield South Carolina, for allegedly failing to reimburse the hospital for providing care to Medicaid patients covered by the BlueChoice managed care plans, according to The Post and Courier.

According to the CEO of the hospital, MUSC has provided more than $4 million in care to BlueChoice members.

The lawsuit filed last month claims the insurer agreed to pay 60 percent of the total charges. The lawsuit alleges that while the insurer has met its obligations for several contracts, it has not successfully paid for all of them, according to the report.

Court records do not indicate how much money the hospital seeks in reimbursement.

MUSC typically does not treat patients covered by BlueChoice managed care plans or the insurer's  Affordable Care Act plan available through HealthCare.gov, according to the report.

BCBS offered to include MUSC in its ACA network, but the hospital declined. Negotiations with the insurance company are ongoing.

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