An insurer for a Tennessee firm embroiled in a medical overbilling scandal is refusing to pay the tab for what it calls “fraudulent conduct,” court records show.
Ironshore Specialty Insurance Company has filed suit in U.S. District Court against Knoxville emergency medical outsourcing firm TeamHealth. The insurer says in the litigation that TeamHealth wants the company to pony up money to cover a $42 million settlement of overbilling claims in Texas.
“The (Texas settlement) arises from and is based upon fraudulent conduct by TeamHealth in submitting false claims to federal healthcare programs in order to receive payments for services that were not provided and/or medically unnecessary,” Ironshore’s lawsuit stated. “The policy does not cover loss in connection with a claim made against an insured alleging, arising out of (or) based upon or attributable to any wrongful act committed with the knowledge that it was a wrongful act.”
TeamHealth pioneered the outsourcing of hospital emergency medical care and is now one of the nation’s largest emergency medicine providers in the country.
The Knoxville-based firm in recent years has been repeatedly accused in courtrooms across the country of scheming to turn emergency rooms into corporate profit centers through “cartel-like” behavior, including price fixing, legal intimidation and fraud.
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