© 2016 The Texas Lawbook.
By Mark Curriden
(June 27) – A federal jury in Dallas last Thursday ordered BlueCross BlueShield of Louisiana to pay McKinney-based Encompass Office Solutions $7.5 million for past unpaid services and tortious interference with its business practices.
Encompass sued BCBS and other major health insurance providers for tens of millions of dollars in 2011 for not reimbursing the company for the ambulatory surgery services provided to doctors to perform minor medical procedures in their private offices, which saved money and improved patient care.
To lead its legal efforts to recover money, Encompass hired lawyers at Thompson & Knight.
Aetna, Cigna, UnitedHealth and other insurance carriers reached out of court settlements.
BCBS of Louisiana decided to fight in court, arguing that the contracts the insurer had with the doctors and anesthesiologists for the surgeries was “all-inclusive” and that forcing them to compensate Encompass for providing equipment and personnel would mean that they were being charged double for the same services.
“Nine out of 10 doctors in Louisiana contracted with BlueCross BlueShield and they have about 75 percent of the patient market,” said Ecklund, who was an associate when the case started. “Doctors were afraid to lose their business.”
Physicians testified that the reimbursements paid by the insurance company did not come close to covering the cost of the services offered by Encompass.
T&K amended its breach of contract lawsuit to include allegations of defamation and tortious interference.
“BlueCross Blue Shield executives flat out admitted on the witness stand that our client’s services were covered,” Ecklund said.
After four days of testimony and arguments, the eight-person jury in U.S. District Court Chief Judge Barbara Lynn’s court deliberated nearly six hours before voting in favor of Encompass and awarding $7.5 million in damages.
Jonathan Herman, Dallas lawyer who represents BCBS, said the company is “disappointed” at the jury’s decision and that he planed to appeal to the U.S. Court of Appeals for the Fifth Circuit.
Ecklund was joined on the trial team by associates Andrew Cookingham and Reed Randel.
BCBS of Louisiana is represented by Herman of the Herman Law Firm in Dallas and BLBS in-house lawyer Andy O’Brien.
© 2016 The Texas Lawbook. Content of The Texas Lawbook is controlled and protected by specific licensing agreements with our subscribers and under federal copyright laws. Any distribution of this content without the consent of The Texas Lawbook is prohibited.
If you see any inaccuracy in any article in The Texas Lawbook, please contact us. Our goal is content that is 100% true and accurate. Thank you.