Health Insurance

Blue Cross wins court skirmish with Westerly Hospital

AN ORDER by Superior Court Judge Brian Stern compels Westerly Hospital to make timely payments on its health insurance premiums to Blue Cross & Blue Shield of Rhode Island through the end of 2012.
Posted 5/11/12

WESTERLY – An order by Superior Court Judge Brian Stern compels Westerly Hospital to make timely payments on its health insurance premiums to Blue Cross & Blue Shield of Rhode Island through the end of 2012.

The order, issued on May 3, also compels the Westerly Hospital to repay the $75,632 that it - and its court-appointed special master, Mark Russo - had withheld.

Based on analysis done by a consultant, the financially troubled 125-bed community hospital claimed that it been overcharged by the health insurer, and began in March to withhold 10 percent of the premium owed.

Blue Cross objected and went to court to seek payment of the full amount of the premium, asking that Stern enforce the existing contracts. If not, the health insurer sought court permission to end health insurance coverage for the employees of Westerly Hospital

A hearing on the conflict was held on April 30 before Stern, which resulted in the order. After the order was issued, Russo said that Westerly Hospital was very pleased to have reached a balanced agreement with Blue Cross.

“We understand that Blue Cross was protecting the interest of its members in filing their motions and appreciate their willingness to discuss options as partners in providing quality health care for our community,” said Russo.

Blue Cross spokeswoman Kim Reingold said the insurer was also pleased to have resolved the issue.

When Westerly Hospital filed for receivership in December 2011, it owed a total of about $2.5 million to Blue Cross, according to reports.

In an unrelated case, Blue Cross and Landmark Medical Center in Woonsocket, which has been in receivership for almost four years, are currently engaged in mediation ordered by Superior Court Judge Michael A. Silverstein to resolve a dispute over money owed by the hospital to the health insurer.

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