East Texas Medical Center Tyler has filed a lawsuit in excess of $1 million against three of the largest health insurance companies in the state — Blue Cross Blue Shield of Texas, Aetna and Cigna — claiming exclusion from their preferred provider networks has created "serious and negative consumer impact."
Specifically, ETMC Tyler alleges that exclusion from the insurers' PPO networks "lessens consumers' choice of quality healthcare providers and increases healthcare costs for some patients." The hospital also claims its exclusion from the networks is contrary to the provisions of the Texas Insurance Code.
"ETMC's involuntary exclusion is unique in the State of Texas in terms of treatment by Blue Cross, Aetna and Cigna," the suit states. For example, of the 271 nonprofit hospitals in Texas, ETMC Tyler is the only general acute-care community hospital involuntarily excluded from the Blue Cross PPO, according to the lawsuits.
ETMC Tyler claims there is no legitimate basis for its exclusion from the PPO networks of Blue Cross, Aetna and Cigna.
An Aetna spokesperson said the insurer has not yet been served with the lawsuit and therefore was unable to provide comment. A Blue Cross Blue Shield of Texas spokesperson said he was unable to comment at this time as this matter is pending litigation. Cigna also does not comment on pending litigation, according to a spokesperson for the company.
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