9th Circ. Lets Surgery Center Pursue $1.3M From Blue Cross

Law360 (December 18, 2020, 6:09 PM EST) -- A Ninth Circuit panel gave a California surgery center a second chance to go after Blue Cross and Blue Shield of Illinois for about $1.3 million, overturning a California federal judge's dismissal of claims that the insurer underpaid the center for 14 patients' procedures.

The panel held in an order Thursday that Blue Cross' argument in federal court — that only the patients of Beverly Oaks Physicians Surgical Center LLC can sue over alleged underpayments — didn't comport with the insurer's previous statements.

"At no time during the presurgery conversations or during the administrative claim process did Blue Cross advise Beverly...

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