City joins ambulance service lawsuit against insurers
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The city of Pittsburgh is one of 13 paramedic service providers statewide that on Friday joined the Ambulance Association of Pennsylvania in suing health insurers statewide, accusing them of "a pattern of attempted extortion" in how they pay bills for patient transport.
The complaint in U.S. District Court's Western District, authored by attorney Charles Kelly of Downtown-based Kelly Hayden LLC, claims that the insurers refuse to pay the ambulance providers directly for their services unless the providers enter into "contracts that would not adequately compensate the providers for their emergency medical services." Instead, the insurers pay the patients, who may or may not then turn the money over to the ambulance providers.
The complaint claims that state law gives the providers the right to get paid directly, even if they have no contracts with the insurers. By insisting on "steeply-discounted rates unilaterally set by the defendants," or refusing to pay the providers directly, they are damaging the ambulance services.
The complaint seeks certification as a class action including some 200 paramedic services, and cites anti-racketeering laws, among other causes of action. Pittsburgh City Council on Thursday voted to pay Kelly Hayden up to $5,000 to represent Pittsburgh.
The plaintiffs so far include the city, the association, Monessen Ambulance Service, Mon Valley Emergency Medical Services, Robinson EMS, Goodwill Hose Company Ambulance Association, Lancaster EMS Association, United Hook & Ladder Co., New Oxford Community Fire Co., Penn Township Volunteer Emegency Services Inc., Tremont Area Ambulance Association, Valley Ambulance Authority, Yoe Fire Company Ambulance Service and Northwest EMS.
Defendants are Highmark Inc., Keystone Health Plan West, Capital Blue Cross, Keystone Health Plan Central, Independence Blue Cross, and the Hospital Service Association of Northeastern Pennsylvania.
Rich Lord: rlord@post-gazette.com or 412-263-1542.
First Published February 12, 2010 7:16 pm
