4 New Jersey ASCs sue SEIU, alleging underpayment for procedures

Four New Jersey ASCs have filed a lawsuit against a Service Employees International Union benefit fund alleging underpayment for nearly two dozen procedures performed on fund participants, according to a May 11 report from Law360.

The four ASCs filed a lawsuit in the U.S. District Court for the Eastern District of New York, claiming breach of contract and unjust enrichment against the 1199 SEIU National Benefit Fund. 

Manalapan Surgery Center, New Horizon Surgical Center in Paterson, Surgicore of Jersey City and Surgicore Center in Saddle Brook allege that they performed $1.4 million worth of procedures on fund participants and were only paid $60,633. 

The centers are seeking $381,670.71 each plus damages, interest and court costs, according to Law360

The centers allege that the fund has not paid them a rate keeping with the "usual, customary and reasonable" rate for service. The fund allegedly underpaid the centers for surgeries performed between 2016 and 2021. 

The ASCs are also alleging fraudulent inducement, claiming the fund led them to believe it would pay a reasonable rate and then underpaid them. They claim that before performing a procedure, they contact the SEIU fund to confirm the surgery will take place and will be covered.

"By confirming that the scheduled surgical procedure was authorized and covered, 1199 SEIU agreed that all component services, anesthesia and use of a facility to perform the surgery, were authorized and covered," the complaint reads. 

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers

Featured Podcast