HUNTINGTON – A health plan alleges that a Barboursville company has failed to pay back funds the plan overpaid.
Michael H. Holland, Michael McKown, William P. Hobgood, Marty Hudson, Joseph R. Reschini, Carl E. Vanhorn and Gail R. Wilensky, as trustees of United Mine Workers of America Combined Benefit Fund, et al. filed a complaint in U.S. District Court for the Southern of West Virginia against Trans-Med LLC citing the Employee Retirement Income Security Act.
The suit states in July 2012, the UMWA Health Plan entered into a medical transportation network preferred provider agreement with the defendant.
The plaintiffs allege that the defendant "fraudulently misrepresented" claims for nonemergency transport services and as a result, they overpaid. The suit states an audit revealed the health plan overpaid the defendant by $197,131 between January 2015 to March 2017.
The suit states the defendant was given the option of refunding the entire amount over a period of time or all at once in a letter dated in October 2017. The defendant has allegedly failed to pay any of the amount owed.
The plaintiffs are seeking all reasonable sums due, attorney fees and court costs. They are represented by Gary Collias in Charleston and Abigail A. Petouvis of the UMWA Health and Retirement Funds Office of the General Counsel in Washington, D.C.
U.S. District Court for the Southern of West Virginia case number 3:19-00180