San Francisco's city attorney has filed a lawsuit against Anthem Blue Cross of California and Health Net for allegedly underpaying 501-bed San Francisco General Hospital and other public hospitals for emergency services.
City files suit against Anthem, Health Net
The complaint, filed in San Francisco Superior Court, also alleges that the insurers deliberately delayed claims payments and “unjustly enriched themselves at the expense of California's public hospitals,” according to San Francisco City Attorney Dennis Herrera.
Citing California's Unfair Competition Law, Herrera said he is seeking an injunction to halt these alleged payment practices, full restitution for all underpayments with interest, civil penalties of up to $2,500 for each violation and reimbursement for the city's legal costs.
“The insurers we've sued are shortchanging public hospitals and sticking taxpayers with the bill,” Herrera said in a statement.
San Francisco General Hospital CEO Sue Currin said in a separate statement, “in order to continue providing these vital services to insured and uninsured patients, it is essential that insurance companies such as Blue Cross and Health Net pay fairly for the care we deliver to their policyholders.”
The hospital, administered by the San Francisco Department of Public Health, has the only level 1 trauma center in the city and receives 30% of all city ambulance traffic.
A spokeswoman for Health Net said the insurer is evaluating the complaint but typically does not comment on pending litigation. Anthem Blue Cross did not respond to a request for comment by deadline.
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