St. Gregory Retreat Centers In Iowa Sues Wellmark Over Refusal To Pay For Pre-Authorized Addiction Treatment

On May 26, 2016, St. Gregory Retreat Centers LLC in Iowa sued Wellmark, a Blue Cross and Blue Shield (BCBS) affiliate in Iowa, over Wellmark’s failure to pay for pre-authorized addiction treatment services by retroactively ruling that the services provided were not medically necessary. The plaintiffs allege that Wellmark is in breach of its network agreements, and owes St. Gregory $12 million in withheld reimbursements for services rendered, plus damages. No hearing date has been set.

The plaintiffs include St. Gregory Retreat Centers, LLC; ALPP Institute, LLC; and Recovery Laboratory Services, Inc. (RLS). St. Gregory Retreat Centers, LLC . . .