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Georgia hospital system sues Blue Cross Blue Shield for Anthem imaging policy

Piedmont Hospital has brought a lawsuit saying the insurer has breached their contract in not paying for some MRI and CT scans.

Susan Morse, Senior Editor

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Piedmont Hospital and five of its affiliates are suing Blue Cross Blue Shield of Georgia over the imaging policy of its parent company Anthem.

Anthem released its new policy in August, saying that as of September 1, it would no longer pay hospitals in five states for outpatient imaging services for MRIs or CT scans. It had initiated the same policy in four other states in July.

[Also: New Anthem policy cuts hospital outpatient payment for MRIs, CT scans in 5 states]

The insurance company said it costs more to have the service done in a hospital than in a freestanding facility -- but imaging is a big part of hospital revenue.

Anthem's policy has resulted in the insurer not paying for the MRIs and CT scans of some of its beneficiaries, according to The Atlanta Journal-Constitution, which reported the lawsuit. Piedmont has said that Anthem's policy represents a breach of their contract, according to the report. 

Blue Cross Blue Shield of Georgia declined comment on Thursday. Piedmont Hospital did not immediately return a request for comment.

The policy is in effect for hospitals in New York, Ohio, Colorado, Nevada, Georgia, Indiana, Kentucky, Missouri and Wisconsin.

Twitter: @SusanJMorse
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