Blue Cross Sued for Failure to Reimburse COVID Testing Costs

On Friday, Saloojas, Inc. filed a complaint in the Northern District of California against Blue Cross of California, Inc. for not covering the healthcare costs incurred by employees for COVID testing, despite it being mandated by the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, Economic Security Act (CARES Act).

Blue Cross is a healthcare provider who worked with Saloojas to provide COVID tests to their customers. By the FFCRA, “all group health plans and health insurance issuers offering group or individual health insurance coverage are required to provide benefits for […] diagnostic testing for the detection or diagnosis of COVID-19.” Also, that healthcare providers must reimburse out-of-network providers “in an amount that equals the cash price for such COVID Testing services.” However, the defendant allegedly denied or underpaid claims made by their customers, and forced Saloojas into a “paperwork war of attrition” to deter them from filing all the necessary claims for their testing services.

Thus, Saloojas is suing for violations of FFCRA and the CARES Act, as well as a violation of the Employment Retirement Income Security Act (ERISA), RICO, promissory estoppel and for fraudulent business practices. By not reimbursing out-of-network providers and covering the costs of COVID tests, they violated their customers’ rights unders the aforementioned laws. The plaintiff also alleged that due to Blue Cross’ “disinformation campaign” and use of “mails and wires in furtherance of the Improper Record Request Scheme,” their actions constituted racketeering. Saloojas is hoping to hold Blue Cross accountable and recoup their losses.

The plaintiff is seeking a declaration that the defendant breached the FFCRA and CARES Act regarding the coverage and reimbursement of the COVID Testing service claims, treble damages, compensatory and consequential damages, lost profits and contractual damages, exemplary damages, pre- and post-judgment interest, attorney’s fees and costs, and other relief.

Saloojas is represented by the Law Office of Michael Lynn Gabriel.