A Rockland, N.Y.-centered doctor has blamed his personal bankruptcy on Fidelis Care health insurance and Spring Valley, N.Y.-dependent Refuah Overall health Centre, Westchester & Fairfield County Business Journals claimed June 7.
Pediatrician and follow operator Seth Kurtz, MD, reported the two providers have produced “concerted action” to block reimbursements to his practice, in accordance to an affidavit submitted in U.S. Bankruptcy Courtroom cited in the Business Journals. Fidelis and Refuah did not answer to e-mail from the publication requesting a remark on the allegations.
QHC Upstate Healthcare submitted for Chapter 11 reorganization on July 5, declaring $366,049 in belongings and $2,289,588 in liabilities. The practice beforehand sued Fidelis for $3 million for allegedly illegally canceling its company arrangement. A Rockland County Supreme Court choose ruled towards the exercise and awarded $1.5 million to Fidelis previous year, a determination Dr. Kurtz has appealed.
In 2020, the practice grossed a lot more than $9 million, according to a bankruptcy program cited by the publication, and revenues virtually doubled previous calendar year.
Following obtaining a health assistance settlement with the follow that was renewed annually due to the fact 2011, Fidelis sent QHC an audit letter demanding $1.9 million for approximately five years of alleged improper billings in 2019. The payer then declared the assistance settlement would not be renewed.
In accordance to Dr. Kurtz, Fidelis did not answer to a request for paperwork to help the alleged $1.9 million in incorrect billings, and the decline of coverage compelled the observe to halt procedure.
The audit letter was portion of a “coordinated, retributive and retaliatory unlawful act initiated by Refuah Well being Center Inc.,” Dr. Kurtz alleged in his affidavit.
“It became significantly evident that Fidelis’ supreme purpose was not to perform with the debtor (QHC) anymore in Rockland County,” Dr. Kurtz stated, according to the Business Journals, “unless of course the terms and circumstances of our romance have been substantially modified.”
QHC is thinking about no matter whether to pursue litigation, Dr. Kurtz explained.