Tower Health Center Sues Government Employees Insurance Co. Over Alleged Payment Reduction

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Tower Health Center, Inc. has filed a proposed class action lawsuit against Government Employees Insurance Company on behalf of a patient whose coverage payment for spinal treatments billed under certain current procedural terminology codes (CPT) was allegedly reduced by two percent in violation of the defendant’s own policies and Florida’s No-Fault motor vehicle law.

“[The plaintiff], on behalf of itself and all others similarly situated, alleges that [the defendant] uniformly and systematically improperly applied the two percent (2%) reduction to the payments of all claims submitted by [the plaintiff] and class members for medical services rendered pursuant to CPT codes 98940 and 98941,” the complaint alleges. “The common injury that [Government Employees Insurance Company] caused [the plaintiff] and class members stems from [the defendant’s] misinterpretation of PFS Final Rule and improper application of the two percent (2%) reduction which was only available to Medicare contractors, not private payers.”