Blue Cross and Blue Shield of Georgia overcharged customers for health insurance while at the same time cutting payments to doctors outside of its coverage “network,” according to a lawsuit filed Monday that seeks class-action status.
The lawsuit, filed by former Georgia Insurance Commissioner John Oxendine on behalf of 11 surgical centers and their patients and a claims filing service, argues that the state’s largest health insurer cut payments to doctors but fraudulently continued charging consumers a premium rate as if they were still making the higher payouts.
Oxendine said hundreds of millions of dollars may be at stake. Blue Cross and Blue Shield of Georgia insures about 3 million Georgians.
Oxendine said Blue Cross justified charging higher premiums or having consumers pay a bigger percentage of their bill out of pocket when seeing an out-of-network doctor because the company paid those providers more money for services.
However, the lawsuit, filed in White County, says Blue Cross began paying those doctors less but didn’t reduce premiums.
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