A federal district court dismissed a lawsuit from a New Jersey spine practice accusing Blue Cross Blue Shield of Illinois of violating the No Surprises Act, Vital Law reported July 28.
Prime Neuro Spine Institute in Montville, N.J., filed the lawsuit seeking confirmation of seven Independent Dispute Resolution determinations and alleging No Surprises Act violations following a conflict over a 2023 spine surgery. The practice submitted a claim to BCBSIL seeking payment, and the insurer remitted $71,941.25.
Prime Neuro Spine Institute invoked the No Surprises Act’s dispute resolution process, and the IDR process led to mixed results. BCBSIL objected to the eligibility of six of the seven IDR proceedings but didn’t participate in or consent to any of the proceedings. In March, the certified IDR entity ruled in the practice’s favor, but the insurer didn’t tender additional payments.
On March 25, the practice filed its two-count lawsuit. However the court determined there wasn’t any evidence BCBSIL deliberately targeted the practice’s protections and benefits establishing jurisdiction.
The lawsuit was dismissed without prejudice, leaving the door open for Prime Neuro to refile its claims.
