In response to the discontinuation of the Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSHP)’s “avoidable ER” program, which reviewed claims on behalf of its individual insured members for payment regarding emergency room services, ACEP and the Medical Association of Georgia (MAG) have agreed to withdraw the lawsuit filed in July 2018 in the U.S. District Court for the Northern District of Georgia. ACEP and MAG originally brought the lawsuit against BCBSHP over concerns the insurer’s program would result in violations to the federal prudent layperson standard.
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ACEP Now: Vol 41 – No 04 – April 2022“This is a mutually successful outcome of a three-year long lawsuit in Georgia,” said ACEP President Gillian Schmitz, MD, FACEP. “We believe this is the best outcome for Georgia patients and emergency providers alike, and this decision will allow our members to focus on providing quality care and treatment to those patients who walk through their doors and to continue to save lives.”
Though the legal applicability of this settlement is limited to Georgia, ACEP believes this case sets a strong precedent nationwide as we fight back against similar dangerous policies in other states.
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