Napoli Shkolnik PLLC Files $40 Million Lawsuit Against Blue Cross Blue Shield of Michigan
Filed in the United States District Court for the Western District of Michigan, the complaint alleges that the state's largest health insurer has been underpaying and wrongfully denying claims related to treatment for substance abuse and other behavioral health disorders.
Jul 31, 2019, 14:37 ET
NEW YORK, July 31, 2019 /PRNewswire/ -- Napoli Shkolnik PLLC filed a lawsuit in the United States District Court for the Western District of Michigan on behalf of four substance abuse treatment centers (Serenity Point Recovery, A Forever Recovery, Behavioral Rehabilitation Services, Best Drug Rehabilitation) against Blue Cross Blue Shield of Michigan (BSBSMI) based upon their failure to properly pay benefits related to substance abuse treatment and other behavioral health disorders for over 4,000 patients. The complaint seeks compensatory damages exceeding $40 million, punitive damages, disgorgement of profits, declaratory and injunctive relief, and attorneys' fees and costs and other relief.
For years, Michigan's largest health insurer has placed profits over the lives of its members. In 2018, the CEO of BSBSMI, a "non-profit" corporation, was paid $20 million while the company reported profits of over $580 million on $29.3 billion in revenue.
Meanwhile, since June 2016, it has unjustifiably slashed benefits and denied claims related to substance abuse and other behavioral health issues. In most cases, the rates paid by BCBSMI for these services are below the actual cost to providers of offering services - and even below the rates paid by Medicaid. This has resulted in the closing of treatment centers and surprise medical bills to patients and families who rightfully believed that treatment would be covered.
The overall effect has been the denial of access to lifesaving services at a time when they are most desperately needed. Michigan is one of the states hardest hit by the opioid epidemic, with an average of 7 Michiganders dying each day from overdose.
Deaths from overdose in Michigan annually exceed the rate of deaths by car accident and firearms in the state, combined. BCBSMI's actions are in violation of the terms of their insurance plans with members, ERISA, the Federal Mental Health Parity and Addiction Equity Act (Parity Act), as well as state laws prohibiting fraud, unfair business practices and other illegal acts.
The case is the Serenity Point Recovery, Inc, et al. v. Blue Cross Blue Shield of Michigan, case number 19-cv-00620, in the United States District Court for the Western District of Michigan.
If you are a substance abuse treatment center or behavioral health facility and believe that Blue Cross Blue Shield of Michigan, or any other commercial insurance company, has been underpaying or wrongfully denying claims, we encourage you to please call us at (212) 397-1000.
About the firm
Napoli Shkolnik PLLC is a national litigation firm providing representation to plaintiffs in class actions and complex commercial litigation, as well as victims of environmental contamination disasters, aviation accidents, defective prescriptions drugs and medical devices, asbestos-related illnesses, and other serious personal injury matters. With their principal offices in New York City and additional offices in California, Florida, Illinois, Michigan, New Jersey, Ohio, Texas, Washington DC and affiliates throughout the United States, Napoli Shkolnik PLLC is readily available to clients.
SOURCE Napoli Shkolnik PLLC
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