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Blue Cross and Blue Shield of Georgia faces separate lawsuits accusing it of sending reimbursement money for emergency room care directly to patients — and not to the hospital because it isn’t part of the insurer’s network.

That’s costing the hospitals money since patients don’t always turn over the funds, according to the lawsuits, filed by Polk Medical Center in northwest Georgia and Martin Luther King, Jr. Community Hospital in Los Angeles — 2,000 miles apart. Each suit also says some patients have sought to profit from receiving the direct payments for their ER...

Blue Shield of California, already under scrutiny by state officials, is facing new criticism that it didn’t adequately pay back doctors and policy holders for excessively spending on administrative costs in 2014.  The allegations were made by a former company executive in a complaint to state regulators.

But if substantiated by investigators, the accusation could force the insurer to pay additional rebates to customers. The complaint also risks becoming another black mark on Blue Shield, California’s third-largest health plan, which already...

Deutsche Bank pledges to update anti-money laundering (AML) processes after failings uncovered by the Financial Conduct Authority (FCA) in a move that's pushing other banks to reassess their own operations.
 

Deutsche Bank fell afoul of the FCA's review of its AML and sanctions systems in March. The FCA found the bank had a number of issues, including out-of-date software while lacking rigorous reviews of its clients before beginning to transact business.
 

Speaking to the FT earlier this month, Werner Steinmüller, Deutsche's head of global transaction banking, says...

This term has come to refer to financing that is available based on the deal itself. The borrower’s credit is not a factor. It is simply a question of numbers, including a loan-to-value ratio that effectively makes the transaction a sure bet for the lender whether or not the investor/borrower is successful in his objectives. Hard-money lending is an important part of the universe of potential financing sources, but it should be utilized only when appropriate safeguards are built into the loan documentation. Otherwise, it can swiftly turn into a "heads I win, tails...

Blue Cross and Blue Shield of Georgia faces separate lawsuits accusing it of sending reimbursement money for emergency room care directly to patients — and not the hospital that delivered the service — because the latter isn’t part of the insurer’s network.

And that’s costing the hospitals money, according to the lawsuits, filed by Polk Medical Center in northwest Georgia and Martin Luther King Jr. Community Hospital in Los Angeles – 2,000 miles apart.

Each suit also says some patients have even tried to profit from receiving the direct payments for their ER care.

The...

A lawsuit filed by a Los Angeles community hospital alleges Blue Cross and Blue Shield of Georgia is retaliating against the provider for being out-of-network by paying patients directly for emergency services.

Martin Luther King Jr. Community Hospital alleges in the lawsuit that the insurer is paying patients rather than the hospital as a way to pressure the hospital to accept its contract rates, or become “in-network.” The 131-bed hospital, which opened in 2015, alleges this payment system makes it difficult to get paid for providing services to the insurer's me...

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