Blue Cross Should Have Looked Before it Leaped

We are pleased to announce that we have successfully defended our client, a dermatopathologist, against claims brought against her by Blue Cross & Blue Shield of Rhode Island.  Blue Cross claimed that more than 400 patients had been given IHC stain tests that it said were “medically unnecessary”.  It sued her for repayment of payments it had made for the tests, but did that without actually examining the files and laboratory records for those patients.  We had the case transferred from state to federal court, hired a neuropathologist to review the charts, and demonstrated that a significant percentage of the test results had been positive, allowing patients to seek timely follow-up care.  At our request the court also determined that the Statute of Limitations had expired on a great number of the claims before Blue Cross filed suit.  In the end Blue Cross “threw in the towel” and dismissed their remaining claims. This case is noteworthy since our client had previously settled claims by Medicare and, because of that, several other lawyers had declined to represent her.  A victory for the doctor – and her patients!  (September, 2018)

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