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Cyrus Dugger

HIP sued over denial of service claims

From NY Business.com

HIP sued over denial of service claims by Gale Scott

Brookdale University Hospital of Brooklyn filed a federal RICO lawsuit against Health Insurance Plan of New York, claiming the insurer denied payments for care given to hundreds of HIP patients.

Naming the health plan and several co-defendants, the hospital charges that over the past four years, the insurer conspired with certain physicians groups to wrongly deny payment to the hospital for HIP patients. The case was filed in U.S. District Court in Brooklyn.

At issue is HIP's interpretation of whether the cases met the test for being "medically necessary." The hospital claims that the insurer, in the guise of improving care, repeatedly refused to authorize admissions that it found did not require hospitalization. (keep reading)

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Posted at 10:44 AM, Apr 13, 2007 in
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