Anthem Blue Cross wins appeal over Children’s Hospital Central California bill
By Barbara Anderson, The Fresno Bee | |
McClatchy-Tribune Information Services |
But a recent court ruling in
An attorney for
The dispute is over what the hospital charged
During the 10-month contract gap, the hospital provided emergency and stabilization services to 896 Blue Cross Medi-Cal patients, according to court documents.
Under state and federal law, the hospital was required to provide the emergency services and
But the hospital also provided treatment to stabilize the patients and payment for those services has been in contention.
The hospital sued
The appeals court says in its ruling issued last week that
The hospital argued that its full billed charges were generally in the mid-range or below and thus represented the reasonable and customary value of the services provided.
The appeals court says
"It is reasonably probable that a result more favorable to
An
"Health care consumers are the ones who end up bearing the cost when a hospital succeeds in collecting fees according to their unsupportable charge master fees," said
"This decision is a significant victory for those like Anthem who are working to keep health care affordable," Ng said.
But
"It will impact the number of providers available to patients in managed care plans," Solomon said.
For now, Children's and
Seven years ago, when the hospital and the insurer could not agree on a contract, thousands of families changed their insurance providers when Children's stopped accepting their
Before the 10-month dispute was resolved and a contract signed, concerned parents carried placards to a meeting of the
The reporter can be reached at (559) 441-6310, [email protected] or @beehealthwriter on
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