Doctors Sue Blue Cross On Cancer Cuts

     ATLANTA (CN) – A group of doctors is taking on Blue Cross of Georgia for arbitrarily reducing pay for cancer treatment.

     The physicians, who operate Northeast Georgia Cancer Care LLC and specialize in cancer and blood disorder treatment, are accusing Blue Cross and Blue Shield of arbitrarily lowering the reimbursement rates for numerous covered cancer infusion drugs, services and procedures, according to the complaint filed in Fulton County Superior Court.
The defendant’s actions are “calculated to maximize its own profits at plaintiffs’ expense without regard to the parties’ contractual obligations or the resulting hardship that defendant’s actions inflict on plaintiffs.”
     In addition, the defendant’s reimbursement practices are a “moving target,” making it difficult to budget or predict payment, according to the complaint. The Explanation of Benefits is also difficult to interpret, the physicians noted.
     The plaintiffs are represented by James W. Boswell of King & Spalding.

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