Insurer, Out-Of-Network Hospital Wage Battle Over Payments To Insureds

Mealey's (March 6, 2018, 2:54 PM EST) -- LOS ANGELES — An insurer paid its insureds when they visited out-of-network providers without regard for whether a valid assignment of benefits was in place, allowing insureds to seek legally mandate care from the provider, and then keeping the reimbursement check, a hospital tells a federal judge in California in a March 5 opposition to summary judgment. But in its own opposition filed the same day, the insurer tells the judge that a “rash of meritless arguments” doesn’t change the fact that the plan precluded the assignment of benefits (Martin Luther King Jr. Community Hospital v. Community Insurance Co., d/b/a Anthem Blue Cross and Blue Shield, et al., No. 16-3722, C.D. Calif.)....