Harris Health Files Lawsuit Against Insurance Company
HOUSTON, Texas — Harris Health has launched a federal lawsuit claiming that one of its insurance providers owes the public hospital system a significant amount in unpaid medical claims. The county contends that these costs could eventually be borne by taxpayers.
The suit has been filed in federal court, with WellPoint Texas, previously known as Amerigroup Texas, as the main defendant. IntegraNet Health Network and independent physician group Van Lang are also mentioned in the case, implicated in the contested claims.
Harris Health, which operates Ben Taub and LBJ hospitals, asserts that the defendants have been delaying payments, undervaluing claims, or outright denying payments for medical services provided to many Medicare patients, as part of a 2004 in-network care agreement.
According to court documents, Harris Health began to see a trend of delayed and denied payments in 2020. The hospital system argues that WellPoint continued receiving fixed Medicare payments from the federal government for these patients while shifting the burden of unpaid costs onto county taxpayers.
In its lawsuit, Harris Health claims that the defendants “caused injury and damage to Harris Health by unreasonably delaying, refusing to pay, or underpaying Harris Health.”
Jonathan Wu, an attorney with the Weaver Law Firm who is not part of the case, has pointed out that disputes between healthcare providers and insurance companies are not unusual. He commented on the tension, saying that insurance firms often strive to ensure they are not overpaying or incorrectly coding claims.
Wu noted that both sides have a vested interest in resolving their differences and reassured that patients shouldn’t expect interruptions in their health coverage while the legal process unfolds. He remarked, “Even if one side wins or loses, it won’t impact current subscribers since it pertains to services already rendered. Harris Health must continue to serve patients, regardless of their insurance status.”
Other defendants involved in the lawsuit have chosen not to comment, citing the ongoing litigation.
