LifeBrite Hospital Group of Stokes filed a motion to dismiss counterclaims against Blue Cross and Blue Shield of North Carolina on June 6 and said the action is a contract dispute between a rural hospital, which billed for its services it provided, and an insurance company that does not want to honor its obligation to pay for those services.
“It is not about billing for services not rendered; there is no allegation that the laboratory services at issue were not provided. It is not a scheme to hide information from the insurance company: BCBSNC knows what laboratory services were provided and the patients who received them,” the document states. “It is not about fraud: Medicare allows rural hospitals to bill and be reimbursed for the very same laboratory services about which BCBSNC complains. BCBSNC’s unsupported fraud allegations should be dismissed and this commercial contract dispute should be remanded to the state court where it belongs.”
Prior to 2017, the hospital was owned by Pioneer Health Services of Stokes County and like many other rural hospital operators, it faced significant financial challenges culminating in a March 2016 bankruptcy filing.
LifeBrite took ownership of the Danbury hospital on January 31, 2017, acquiring it in a bankruptcy proceeding.
Blue Cross stated in legal claims filed on May 16 that LifeBrite engaged in a fraudulent scheme by billing for laboratory services that were not payable and in violation of Blue Cross NC’s contract with LifeBrite.
LifeBrite spokesperson Sarah Mann immediately rebuffed the claims.
“It appears that Blue Cross has failed to take into account the role LifeBrite plays in providing high-quality health care to residents of Stokes and surrounding areas. We believe the decision reflects a fundamental misunderstanding about who we are and how we do business, and we are confident that our billing practices are lawful, appropriate and consistent with LifeBrite’s contract with BCBS of North Carolina. We intend to work with BCBS of North Carolina to address any issues in the hopes of continuing our relationship so we can keep providing vitally needed healthcare services to our community.”
Amanda Dodson may be reached at 336-813-2426.