Nonbinary person sues IBX for alleged overbilling

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A nonbinary person who lives in Yardley, Pa. is suing Independence Blue Cross for allegedly overbilling them for STD screenings, including a screening for HIV.

Ryan Marquette, 31, filed suit against the insurance carrier on April 15. Marquette’s 15-page lawsuit alleges breach of contract and violations of the Affordable Care Act.

In March 2024, Marquette received an insurance bill of $1,382.85 from Independence Blue Cross for STD screenings conducted in January 2024, according to the lawsuit.

Marquette alleges that Independence Blue Cross unlawfully overbilled them for services that should have been entirely covered by the insurance carrier.

“Upon information and belief, [Blue Cross] does not ensure coverage of [STD] screenings without cost sharing for transgender nonbinary individuals even though these individuals may be at an increased risk of HIV infection,” the lawsuit alleges.

Such “callous” disregard for the rights of Independence Blue Cross policyholders places the LGBTQIA+ community at increased risk of serious illnesses, according to the lawsuit.

Additionally, Marquette contends that members of the LGBTQ+ communities are routinely overbilled by Independence Blue Cross.

“[Marquette] brings this lawsuit to ensure access to [STD] care for all members of the LGBTQIA+ community at an increased risk of infection with sexually transmitted infections,” the lawsuit states.

The lawsuit alleges that Blue Cross Defendant demonstrated a “reckless disregard” for Marquette’s rights. Moreover, Blue Cross violated its public policy of treating policyholders fairly and equitably.

“[Blue Cross] does not insure LGBTQIA+ people on an equal and non-

discriminatory basis despite what [Blue Cross] may publicly claim,” the lawsuit alleges.

The lawsuit goes on to state that Independence Blue Cross puts profits over community well-being.

“[Blue Cross] places profits over patient safety and the well-being of the LGBTQIA+ community,” the lawsuit adds. “Blue Cross wants to avoid paying legitimate claims. [Blue Cross] will not cover a basic [STD] test without cost sharing.”

The actions of Independence Blue Cross place vulnerable populations at increased risk for contracting sexually-transmitted diseases, contrary to provisions of the Affordable Care Act, according to the lawsuit.

“[Blue Cross] has made a large profit at the expense of the LGBTQIA+ community,” the lawsuit emphasizes.

There was no legitimate basis for Independence Blue Cross to overbill Marquette and to subject the community to increased STD rates, according to the lawsuit.

Marquette is seeking compensatory and punitive damages from Independence Blue Cross, along with a judicial declaration requiring Independence Blue Cross to cover LGBTQIA+ policyholders in a lawful manner.

The case has been assigned to U.S. District Judge Karen S. Marston. A jury trial has been requested. 

Justin F. Robinette, an attorney for Marquette, said the lawsuit may help others in Marquette’s situation.

“Many people may have this [alleged overbilling] happen to them all the time and they may not know it’s illegal under the Affordable Care Act,” Robinette said in an email. “My client brought this lawsuit in the hope that this case will change things for people, and create the opportunity for Independence Blue Cross and other health care organizations to follow the law and protect people in the community who may not fully know their rights.”

Grant Gegwich, a spokesperson for Independence Blue Cross, issued this statement: “Absent a HIPAA authorization, Independence Blue Cross (IBX) is not legally permitted to share information about our members’ health care and/or treatments. In addition, IBX has not been served with the complaint and cannot comment on pending litigation. Please note that IBX is in compliance with the Affordable Care Act and provides coverage for all preventive services mandated by it.”

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