Skip to content
Home » Onondaga County » TLC, other CNY ambulance services sue Excellus for $1M over underpayment

TLC, other CNY ambulance services sue Excellus for $1M over underpayment

  • / Updated:
  • Staff Report 

Several Central New York ambulance companies have filed a lawsuit against Excellus BlueCross BlueShield and its CEO, James Reed, alleging underpayment for their services. The companies involved include TLC Medical Transportation Services, Inc., TLC Emergency Medical Services, Inc., Oswego County Ambulance and Hearse Services, Menter Ambulance, and Fingerlakes Ambulance EMS, Inc.

The lawsuit, seeking $1 million, accuses Excellus of breaching an implied contract and unjust enrichment by misclassifying their services as hospital-based care rather than prehospital ground ambulance care. This misclassification, the plaintiffs claim, has led to gross underpayment by Excellus.

The plaintiffs’ lawyer asserts that the ambulance services have been operating in good faith, while Excellus has refrained from commenting on the ongoing litigation.

This legal action comes amid another dispute between Excellus and WellNow, an urgent care company. Their failure to agree on reimbursement rates means Excellus members will now have to pay out of pocket for services at WellNow Urgent Care centers.

Excellus responded to the situation with WellNow, stating that the urgent care provider chose to leave their network. The insurance company expressed disappointment but is now focusing on assisting members with plan coverage and care options. This series of disputes highlights ongoing tensions between healthcare providers and insurance companies over reimbursement practices and rates.