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Health care clinic alleges Blue Cross and Blue Shield breached patient contracts

FLORIDA RECORD

Monday, November 25, 2024

Health care clinic alleges Blue Cross and Blue Shield breached patient contracts

Healthcare

MIAMI – A Florida health care provider is suing Blue Cross and Blue Shield of Alabama, alleging the insurance company breached contract after failing to pay for patients’ services.

American Clinical Solutions LLC filed a federal lawsuit on Jan. 4 in the U.S. District Court for the Southern District of Florida against Blue Cross and Blue Shield of Alabama, citing violations of the Employee Retirement Income Security Act (ERISA).

The claim being filed has been amended twice from an original complaint filed on Sept. 2. The defendant reportedly was never served with the initial complaint, and the second complaint, filed Dec. 10, is within the 30-day notice of removal period. Both former claims were filed at the state level, the suit states.

According to the claim, the plaintiff provided medically necessary clinical laboratory services to its patients, which were not compensated by the defendant. American Clinical Solutions alleges that the defendant breached insurance contracts for not making proper payments on behalf of the insured patients after laboratory services were provided. The plaintiff avers that the ERISA preempts all state laws and claims regarding employee benefit plans, which it contests represents violations concerning the defendant’s failure to pay for patients’ services.

American Clinical Solution seeks proper removal of the case to the U.S. District Court for the Southern District of Florida. It is represented by Gregory R. Hawran of Ogletree, Deakins, Nash, Smoak & Stewart, P.C., in Miami.

U.S. District Court for the Southern District of Florida Case number 9:16-cv-80012

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