Molly L. Wiltshire

3 weeks ago | afslaw.com | Alison Andersen |Molly L. Wiltshire |David Greenberg |Roberto Martinez

In the complaint, BCBSGA accuses Sound Physicians (a large, multistate physician group) and its subsidiaries, together with HaloMD, Inc., of systematically submitting thousands of ineligible disputes to the NSA’s IDR process. BCBSGA alleges the scheme involved falsely attesting to claim eligibility, overwhelming the IDR process, and inflating offers, resulting in millions of dollars being improperly awarded to Sound Physicians on those claims.