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DISTRICT COURT HEARING POSTPONED FOLLOWING BCBS MOTION TO HAVE CASE HEARD IN FEDERAL COURT

FOR IMMEDIATE RELEASE

(Knox City, September 9, 2019) – The September 10 hearing on the Temporary Restraining Order (TRO) issued against Blue Cross Blue Shield of Texas (BCBS) by the 50th District Court of Texas has been postponed pending the BCBS effort to have the case moved to federal court.

Texas District Judge Bobby Burnett, presiding Judge in the 50th District Court of Texas issued a Temporary Restraining Order (TRO) ordering the company to pay Knox County Hospital more than $21 million in unpaid insurance claims last month. In response BCBS filed a motion in the U.S. District Court for Northern Texas, Wichita Falls Division, seeking to move the lawsuit filed against them by Knox County Hospital from state district court to a federal court, since the company is headquartered in Chicago, Illinois.

“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. “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.”

“This legal tactic is certainly keeping in line with the company’s policy of non-payment, delay and obfuscation that the Knox County Hospital has been dealing with for more than two years,” Dawson said. “Knox County wants its day in court.”

“This latest move by Blue Cross is consistent with the company’s bully pattern of delay, obstruction and stall tactics to avoid paying claims,” Dawson said.

The Texas District Court’s restraining order was based on the following conclusions of law;

  • Blue Cross Blue Shield has willfully and wantonly undertaken acts to secure funds which do not belong to them;
  • Blue Cross Blue Shield engaged in slanderous activities;
  • Blue Cross Blue Shield willfully and wantonly breached a duty of care;
  • Blue Cross Blue Shield willfully and wantonly violated the Insurance (regulations) of the

    state of Texas;

• The Court deems these acts to be willful conduct of fraud.

The TRO against Blue Cross Blue Shield of Texas, issued on August 16th, ordered the company to allocate the funds owed to Knox County Hospital within 24 hours. Blue Cross Blue Shield has failed to comply with the TR O.

“It is no wonder that Texas leads the nation in rural hospital closures when we have insurance companies bullying hospitals by withholding funds. Small rural hospitals simply cannot survive years of nonpayment,” added Dawson.

Blue Cross Blue Shield of Texas stopped making reimbursement payments to Knox County Hospital in June of 2017. It wasn’t until October of 2017 that the company finally responded to inquiries by claiming it was a computer glitch. Knox County Hospital continued to treat Blue Cross Blue Shield subscribers and submit claims. Blue Cross Blue Shield continued to withhold reimbursement.

The Knox County Hospital District then sought intervention from the Texas Department of Insurance which did not prove successful.

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About Knox County Hospital District:

Knox County Hospital District provides healthcare services for residents of Knox County and surrounding areas. The hospital district offers a wealth of medical services, including 24-hour emergency care, advanced radiology services, a clinical laboratory, physical therapy, patient education and more. The Knox County Hospital is a 25-bed acute care critical access facility located in Knox City, Texas. The District also operates two rural health clinics, an outpatient retail pharmacy, home health, emergency medical services (EMS), a nursing home and durable medical equipment (DME) services.

About Knox County:

Knox County is located approximately 120 miles west of Lubbock. It has a population of nearly 4,000 according to the 2010 census. The county seat is Benjamin, Texas.

Contact: Chuck McDonald 512-658-5958 Mcdonaldpr.charles@gmail.com

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.

Texas Judge orders Blue Cross Blue Shield of Texas to pay Knox County Hospital $21 million in past due billing

FOR IMMEDIATE RELEASE
August 20, 2019

(Knox City August 20, 2019) – A Texas District Judge issued a Temporary Restraining Order (TRO) against Blue Cross Blue Shield of Texas and ordered them to pay more than $21 million in unpaid insurance claims owed to the Knox County Hospital.  Bobby Burnett, presiding Judge of the 50th District Court of Texas which includes Knox County,  ordered Blue Cross Blue Shield to pay all funds which are allocated to Knox County Hospital within 24 hours of issuing the TRO which the company received at its Chicago headquarters on August 15.  Blue Cross Blue Shield has failed to do so.

Blue Cross filed a motion in the U.S. District Court for Northern Texas, Wichita Falls Division, to have the case moved to federal court.

“The venue is irrelevant. Knox County is looking forward to its day in court – be it state or federal,” said Kelly Dawson, attorney for the Knox County Hospital District. “The fact is that Blue Cross has not complied with the restraining order issued by a Texas District Court.”

The Court’s restraining order was based on the following conclusions of law;

  • Blue Cross Blue Shield has willfully and wantonly undertaken acts to secure funds which do not belong to them;
  • Blue Cross Blue Shield engaged in slanderous activities;
  • Blue Cross Blue Shield willfully and wantonly breached a duty of care;
  • Blue Cross Blue Shield willfully and wantonly violated the Insurance (regulations) of the state of Texas;
  • The Court deems these acts to be willful conduct of fraud.

The order also noted that the hospital would suffer permanent and irreparable harm without intervention by the Court. Furthermore, the Judge found that there is a strong likelihood that the  Knox City Hospital District will prevail on the merits of its case in the 50th District Court.

“Clearly the Court recognized the enormous financial harm that could be done to the hospital if Blue Cross Blue Shield continues to withhold monies due to the hospital since 2017 and expects us to prevail in court,” Dawson said.

“It is no wonder that Texas leads the nation in rural hospital closures when we have insurance companies bullying hospitals by withholding funds. Small rural hospitals simply cannot survive years of nonpayment,” added Dawson.

Blue Cross Blue Shield of Texas, owned by Chicago-based Health Care Service, stopped making reimbursement payments to Knox County Hospital in June of 2017.  It wasn’t until October of 2017 that the company finally responded to inquiries by claiming it was a computer glitch.

The hospital continued to treat Blue Cross Blue Shield subscribers and submit claims.  Blue Cross Blue Shield continued to withhold reimbursement.

The Knox County Hospital District then sought intervention from the Texas Department of Insurance which did not prove successful.

The hospital’s lawsuit also outlines numerous slanderous allegations by Blue Cross Blue Shield that the rural hospital provider submitted fraudulent claims.

“Blue Cross Blue Shield lied about a computer glitch. They later lied that payments were forthcoming. It is the height of arrogance to slander the hospital while unlawfully withholding funds owed for more than two years,” said Dawson.

A hearing on the Temporary Injunction has been set for September 10.

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About Knox County Hospital District:

Knox County Hospital District provides healthcare services for residents of Knox County and surrounding areas. The hospital district offers a wealth of medical services, including 24-hour emergency care, advanced radiology services, a clinical laboratory, physical therapy, patient education and more. The Knox County Hospital is a 25-bed acute care critical access facility located in Knox City, Texas. The District also operates two rural health clinics, an outpatient retail pharmacy, home health services, emergency medical services (EMS), a nursing home and durable medical equipment (DME) services.

About Knox County:

Knox County is located approximately 120 miles west of Lubbock. It has a population of nearly 4,000 according to the 2010 census. The county seat is Benjamin, Texas.

More Info:

www.knoxcountyhealthcare.org

 

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.

Hamlin Memorial Hospital closing its ER and ceasing inpatient care and other services

Four things to know:

1. The hospital’s board of directors unanimously voted June 29 to discontinue the services — a move that will result in about 35 people losing their jobs, according to local TV station KTXS

2. Effective Aug. 1, HMC will offer services at its walk-in clinic, Hamlin Medical Clinic, according to KTXS.

3. The hospital is facing financial challenges, according to a press release on its Facebook page.

4. “Over the past many years inpatient utilization has decreased to the point that there are many days that there is no one in the hospital,” the hospital said. “After an in-depth study of all departments in the hospital, income vs. expenses, it became very evident that Medicare, Medicaid, and most private insurance reimbursements did not come close to covering continually rising expenses. A declining tax base and tax payment delinquencies have also contributed to the financial hardships.”