Blue Cross and Blue Shield of Texas must pay $108,341,934.10 to Rockdale Blackhawk LLC, which used to be known as Little River Healthcare in Milam County.
According to court records from the U.S. Bankruptcy Court Western District of Texas, Waco Division, Texas Supreme Court Judge Harriet O’Neill awarded that amount to Rockdale Blackhawk during an arbitration proceeding.
Little River first filed for arbitration in 2018, claiming BCBSTX breached various contracts regarding laboratory services it insured. Little River also accused BCBSTX of violating the Texas Prompt Payment laws.
BCBSTX argued Little River committed fraud in its laboratory services billing.
After reviewing the case, Justice O’Neill found in favor of Little River regarding its contractual claims, as well as attorneys fees, interests, and costs.
Little River Healthcare closed unexpectedly in 2018, forcing hundreds of Central Texans to search for new doctors.
Despite the arbitration decision, Blue Cross Blue Shield of Texas says Justice O’Neill agreed that its investigation into Little River was justified and that there was a ‘genuine disagreement’ over whether Little River’s billing practices were permissible under.
The company also sent FOX44 News this statement:
While Blue Cross and Blue Shield of Texas is pleased the arbitrator denied the vast majority of Little River’s claims, BCBSTX is disappointed with the ruling allowing Little River to recover for lab services performed by third parties or for people who never visited the hospital. BCBSTX is committed to standing by its members and its customers in challenging billing practices that may be fraudulent, wasteful, or abusive.“Blue Cross and Blue Shield of Texas