STAT+: HaloMD faces lawsuit alleging No Surprises Act middleman used ‘sham letter,’ misleading data

A fourth major health insurer is suing Halo MD over its use of the No Surprises Act’s arbitration process, arguing that the middleman deceived arbitrators by sending them a “sham letter” and misleading price data.&#x A0; Highmark Health, a Pennsylvania-based Blue Cross Blue Shield licensee with over 7 million members, claims in a complaint filed June 1 in U.S. District Court in Western Pennsylvania that Halo MD and one of its clients, a neuromonitoring provider called Bromedicon, submitted more than 450 ineligible disputes with the company and won more than $3.9 million. Like the three Blue Cross plans before it, Highmark wants those awards tossed and its money returned. “Defendants’ scheme is not a good faith attempt to obtain fair reimbursement,” Highmark’s complaint says. “It is a deliberate effort to wrongfully extract inflated payments from Highmark.” Continue to STAT+ to read the full story…