Legal Opinion
Baptist Physician Hospital Organization, Inc. Baptist Hospital of East Tennessee v. Humana Military Healthcare Services, Inc.
Court of Appeals for the Sixth Circuit
Decided May 25, 2004No. 03-5084PublishedCited by 14 opinions
1Opinion of the Court
MERRITT, Circuit Judge.
In this diversity contract action governed by the substantive law of Tennessee, Baptist alleges that Humana, a private government contractor administering the managed healthcare program in Regions 3 and 4 for the Department of Defense, underpaid Baptist for eighty-five separate claims for a total underpayment of over $1.3 million. The Humana Baptist contract defines a reimbursement scheme that is the center of the controversy. Humana has raised a defense to payment based on federal regulations limiting amounts that the government itself will pay to Humana as…
2Cases cited8 opinions
- Graham A. Peters v. The Lincoln Electric CompanyCourt of Appeals for the Sixth Circuit · 2002
- Farmers-Peoples Bank v. ClemmerTennessee Supreme Court · 1975
- Hamblen County v. City of MorristownTennessee Supreme Court · 1983
- Gredig v. Tennessee Farmers Mutual Insurance Co.Court of Appeals of Tennessee · 1994
- Bokor v. HolderCourt of Appeals of Tennessee · 1986
3 more not listed; retrieve them via the Exa API.
3Cited by14 opinions
- United States Ex Rel. Polukoff v. St. Mark's Hosp.Court of Appeals for the Tenth Circuit · 2018
- Shirt v. HazeltineDistrict Court, D. South Dakota · 2004
- Baptist Physician Hospital Organization, Inc. And Baptist Hospital of East Tennessee, Inc. v. Humana Military Healthcare Services, Inc.Court of Appeals for the Sixth Circuit · 2007
- Jerry Duncan v. Leonard MuzynCourt of Appeals for the Sixth Circuit · 2018
- Board of Trustees of Bay Medical Center v. Humana Military Healthcare Services, Inc.Court of Appeals for the Federal Circuit · 2006
9 more not listed; retrieve them via the Exa API.