A proposed class-action lawsuit pending in Texas federal court alleges Dallas-based Steward Health Care and Medical Reimbursements of America engaged in billing fraud in auto accident injury cases, according to the Texarkana Gazette.
The lawsuit, filed in July, alleges Medical Reimbursements of America sought to boost Steward's revenue by using illegal methods to increase reimbursement. The lawsuit was filed by a former patient who claims MRA didn't bill her health insurance plan for services rendered after an auto accident.
The plaintiff, Beverly Williams, received care at Steward's Wadley Regional Medical Center in Texarkana, Texas, after an automobile accident in 2018. She alleges that the hospital and MRA engaged in a scheme to boost reimbursement that involved violating the hospital's contract with Blue Cross Blue Shield of Texas.
"At the time the services were provided, Plaintiff maintained health insurance through Blue Cross Blue Shield of Texas, which is honored by Wadley Regional Medical Center and for the payment of service at established rates," states the complaint. "However, Defendants did not bill BCBST for services rendered to Plaintiff. Instead, Defendants, acting alone or in concert with each other, engaged in an unlawful, deceptive scheme of revenue enhancement through the collection of charges which Wadley ... did not ever rightfully possess as asserted and certainly now no longer possess."
The complaint alleges that the hospital and MRA sought payment for an inflated bill from Safeway, which insured the driver of the car that hit the vehicle Ms. Williams was in, according to the report.
The lawsuit was filed on behalf of Ms. Williams and other Texas patients in situations similar to the plaintiff.
"Based upon Defendants' formalized revenue enhancement scheme as evidenced by their conduct and written correspondence, Plaintiff alleges her situation is not isolated," states the complaint.
The complaint accuses Steward and MRA of violating the Texas Deceptive Trade Practices Act and the Texas Finance Code, as well as of committing fraud, according to the report.
Steward and MRA did not respond to the Texarkana Gazette's request for comment.
Access the full Texarkana Gazette article here.