Child and Family Development — Reported Address of Sued Practice
Blue Cross and Blue Shield of North Carolina has filed a lawsuit accusing a Charlotte-based children’s therapy practice of submitting $1.1 million in fraudulent insurance claims, alleging the company billed for services with no proof they were ever delivered. The insurer wants a court to force Child and Family Development, Inc. to pay back the money, plus damages, interest and legal costs.
The lawsuit, filed in early September, accuses Child and Family Development of improper and fraudulent billing tied to $1.1 million in what Blue Cross NC calls unearned claims, according to the Charlotte Observer. Blue Cross NC filed the case in the Superior Court Division of Durham County before it was assigned to the North Carolina Business Court, which handles complex business litigation, as reported by Yahoo News. This was not Blue Cross NC’s first attempt at the case — in the earlier case, Child and Family Development filed a motion to dismiss, and a judge later ordered additional briefs before ruling on that motion, according to the Charlotte Observer. The insurer filed its new complaint on September 2, according to WSOC TV.
What the Insurer Says Went Wrong
The allegations center on evaluation and management billing codes submitted between August 2017 and July 2022 for administrative duties that Blue Cross NC says were performed alongside physical, occupational and speech therapy services, per the Charlotte Observer’s reporting. The insurer’s special investigations unit flagged the practice in January 2023 and requested medical, operational and credentialing records for a random sample of 419 member claims, the outlet’s report states…