EDWARDSVILLE - A hospital has filed suit against an insurance plan provider for allegedly failing to cover the costs of services to Medicaid recipients.
St. Joseph's Hospital filed suit April 21 against Harmony Health Plan for allegedly failing to pay nearly $120,000. Harmony Health Plan did not immediately respond to a request for comment.
The Highland hospital states it had a contract with Harmony Health to provide services to Medicaid patients enrolled in one of its plans. The contract ran Feb. 1, 2009 to July 15, 2018.
In its suit, the hospital claims that Harmony Health breached the contract by failing to pay a total of $114,867 for services provided during the period.
Further, the hospital claims that when there was no contract in place after July 2018, it still provide emergency services that should have been covered by Harmony. The total was $4,521, according to the complaint.
Harmony Health is also accused of unjust enrichment because it received the benefit of services but did not pay.
Under Illinois statutes, the defendant is also liable to pay penalties amounting to 60 percent of the total claimed, the suit states.
St Joseph's is demanding nearly $120,000 in costs and $71,633 in penalties.
The hospital is represented by Jeffrey Fink of Thompson Coburn in St. Louis.
Madison County Court case number 2020-L-0568