Tenn. Doctors, Blue Cross and Blue Shield Agree To Bundle Payments For Knee, Hip Replacements
In other insurance company news, BlueCross Blue Shield of Illinois will pay $25M to settle coverage denial claims.
Modern Healthcare: Tenn. Blues, Doc Practices To Bundle Payments
Four Tennessee orthopedic practices have inked an agreement with Blue Cross and Blue Shield of Tennessee to establish a bundled-payment system for total knee and hip replacements. ... The payment model, expected to debut on Oct. 1, will provide a set fee for the entire episode of care, from surgery to postoperative care and physical therapy, according to a Tennessee Blues news release (Kutscher, 5/22).
Chicago Sun-Times: BlueCross BlueShield To Pay $25M To Settle Coverage Denial Claims
A Chicago-based insurance company will pay $25 million to settle claims that it illegally terminated insurance coverage to sick children in need of in-home nursing care to shift the costs of their treatment to Medicaid. The U.S. Attorney's office and Illinois Attorney General's office on Thursday announced the settlement with BlueCross BlueShield of Illinois over allegations that it fraudulently denied coverage for nursing care to children and other technologically-dependent patients to shift the high cost of their care to the program funded by the state and federal governments (5/23).