QLG Stops A Health Insurer From Recouping $6 Million From a Group of Medical Practices In Georgia
When a health insurer began a campaign to recoup millions of dollars it paid on past claims from a variety of medical practices, Richard Quadrino put together a group of clients and lawyers to fight back, with Quadrino Law Group acting as the lead voice for the group.
Prior to hiring counsel, all of the medical practices had “cooperated” with the health insurer’s audit request and produced medical records on closed, paid claims, not knowing that they had the right to refuse, under ERISA. After providing the records, one practice received a letter from the health insurer demanding that it repay $1.3 million in payments it received for a series of tests conducted on its patients. Others received similar letters demanding between $550,000 and $800,000 and the insurer was exerting extreme pressure upon the medical practices to render prompt repayment.
Quadrino Law Group was hired and coordinated a single response, on behalf of all of the medical practices, using ERISA as the main tool to defeat the recoupment. The health insurer chose not to proceed with its recoupment demands. Business returned to normal for all of the clients, without a single dollar being repaid by any of them to the insurer. No litigation was necessary, since Quadrino Law Group resolved the matter through correspondence with the health insurer.