Amid Court Battle, BCBS Ends Contract with Knox County Hospital for Federal Employees

Federal employees and retirees in Knox County received notice a day after open enrollment ended that their local hospital would no longer be in-network for Blue Cross Blue Shield’s Service Benefit Plan.

In a statement sent to the Times-Record News, BCBS of Texas said the following plans would not longer have Knox County Hospital District in network for the following plans.

The company directed patients to hospitals 20 and 40 miles away to remain in-network. The statement sent to the Times-Record continues, “Members being treated for a pregnancy, disability, acute condition or life-threatening illness may have continuity of care benefits. This means they may still be able to see their current doctor at Knox County Hospital for a limited time after the hospital goes out of network.”

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Knox County Hospital, Blue Cross Blue Shield headed to arbitration in $21 million lawsuit

A $21 million lawsuit by Knox County Hospital District against Blue Cross and Blue Shield of Texas is headed to arbitration.

Federal District Judge Reed O’Connor issued the ruling in December, forcing the two battling entities to conclude the majority of the matter outside of court.

Knox County Hospital District’s termination claim was exempted from arbitration, though. Once the two have concluded the process, O’Connor ruled, they’ll return to court to finish the process.

Knox County viewed the decision as a positive, saying through a news release Monday that O’Connor’s ruling leaves open the possibility of returning to court if a solution cannot be found.

“The judge has made it clear that he wants this matter resolved in a timely fashion, and we will move quickly to meet his order,” Kelly Dawson, attorney for the hospital district, said in the release. “We’re pleased to have the option of coming back to court if we are unable to resolve some of the serious financial hardships that have been imposed on the Knox County Hospital.

“We want the citizens of Knox County to be fully covered before this issued is resolved.”

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Knox County Hospital District files response to BCBS in federal court

The Knox County Hospital District filed an amended complaint against Blue Cross Blue Shield of Texas in the U.S. District Northern District of Texas, hospital officials announced Monday.

Blue Cross Blue Shield of Texas was ordered in August by a Texas district judge to pay more than $21 million in unpaid insurance claims owed to the Knox County Hospital, which claimed the insurance company, among other accusations, committed "acts to be willful conduct of fraud."

Blue Cross-Knox City Conflict May Be Going to Federal Court

Blue Cross Blue Shield of Texas is hoping to move the legal battle with Knox County Hospital District to federal court, and the temporary restraining order hearing scheduled for September 10 has been suspended.

After 50th District Court Judge Bobby Burnett issued the TRO ordering BCBS to pay Knox County Hospital more than $21 million in what they allege are unpaid insurance claims, BCBS filed a motion in U.S. District Court for Northern Texas in Wichita Falls to move the case to federal court because BCBS of Texas is owned by Health Care Services Corporation in Chicago.

“Blue Cross Blue Shield of Texas is hiding behind its legal status in another state to claim that a Texas District Court is not qualified to hear this case,” said Kelly Dawson, the attorney for Knox County Hospital District via release. “Texans are qualified to pay premiums and provide care on behalf of Blue Cross, but Blue Cross doesn’t think they’re qualified to decide if the company is operating illegally when it comes to paying a local Texas hospital.”

Hearing over $21M in alleged unpaid BCBS claims to Texas hospital postponed

A hearing scheduled for Sept. 10 regarding a Texas hospital's temporary restraining order against Blue Cross Blue Shield of Texas has been pushed back, according to a press release from the hospital.

The hearing has been postponed as BCBS aims to move the case to federal court.

In August, a Texas district judge issued a temporary restraining order against BCBS to make it pay Knox County Hospital in Knox City $21 million in alleged unpaid claims. BCBS filed a motion to move the case to a federal court, as its parent company is headquartered in Chicago.

In August, BCBSTX told Becker's in an emailed statement it intended to "vigorously defend against the hospital's allegations."

Knox County Hospital vs BCBS: Why this 25-bed facility is taking on the giant insurance company

The Knox County Hospital District, "tired of having payment withheld without cause," expects to see its $21 million claim against Blue Cross Blue Shield of Texas go to federal court.

The hospital, located about 90 miles west of Wichita Falls and 120 miles east of Lubbock, sees itself fighting a battle for other rural hospitals negatively affected by a corporate giant.

"There are a lot of rural hospitals getting squeezed by big insurance companies who see us not worth their negotiations," said Chuck McDonald, a public relations consultant working with the Knox County Hospital. "We will prevail to make sure that all hospitals of all sizes are treated fairly."

For now, said McDonald, a hearing date of Sept. 10 is still on the books.

BCBS of Texas Ordered to Pay $21 Million for “Willful Conduct of Fraud”

A Texas judge has ordered Richardson’s Blue Cross Blue Shield of Texas to pay more than $21 million to Knox County Hospital in unpaid insurance claims because of “acts to be willful conduct of fraud,” according to the Times Record News in Wichita Fallas.

Bobby Burnett, the presiding judge of the 50th District Court of Texas, also placed a temporary restraining order against BCBS, according to a release from Knox County Hospital District. The restraining order says it was placed because BCBS willfully secured funds that did not belong to them, they engaged in slanderous activities, breached duty of care, and violated insurance regulations of Texas.

Texas district judge orders BCBS of Texas to pay $21 mil to Knox County Hospital

Blue Cross Blue Shield of Texas has been ordered by a Texas district judge to pay more than $21 million in unpaid insurance claims owed to the Knox County Hospital, claiming the insurance company, among other accusations, committed "acts to be willful conduct of fraud."

The judge's actions, according to a release from the Knox County Hospital District, also included a temporary restraining order against BCBS of Texas.

Bobby Burnett, presiding judge of the 50th District Court of Texas, ordered BCBS of Texas to pay all funds allocated to the Knox County Hospital within 24 hours of the restraining order's issuance.

BCBS of Texas: Will ‘vigorously defend against the hospital’s allegations’

Blue Cross Blue Shield of Texas, after a Texas district judge issued a temporary restraining order and ordered the insurance company to pay Knox County Hospital $21 million in unpaid claims, prepares to fight the allegations in federal court.

Chris Callahan, senior director of media and public relations for BCBS of Texas, told the Times Record News Wednesday in a statement on behalf of the company that the allegations were based on the hospital's claims and that Knox County Hospital had not notified BCBS of the suit.

Van Zandt Regional Medical Center in Grand Saline closes abruptly

The closure was announced Aug. 4 via a post on Van Zandt Regional Medical Center’s Facebook page. Medicare cutbacks, dwindling reimbursement from insurance companies and a financial burden left by previous management were among the factors that forced the hospital to close, according to CBS19.

Van Zandt Regional Medical Center was the only emergency services provider in Van Zandt County, and a group of local physicians are trying to restore those services. Hospital management is in negotiations with a physician group that is interested in taking over the hospital, according to CBS19.