News Headlines Article

Blue Shield of Calif. ‘drastically’ underpaid for ER services, jury says
Modern Healthcare

A federal jury decided Tuesday that insurer Blue Shield of California underpaid a California hospital system for emergency medical services provided to Blue Shield’s members.The jury in the U.S. District Court in San Francisco determined that Blue Shield must pay out-of-network NorthBay Healthcare Group 67% of its billed charges since the end of 2016. King & Spalding, the law firm representing NorthBay, estimated that it would recover more than $16 million, but the exact amount has not yet been decided.In a statement, however, Blue Shield said the case went to trial because the amounts NorthBay charged for emergency services ran counter to its goal of providing “quality care that is sustainably affordable.”