**Anthem Health Plans of Virginia Sues Multiple Defendants Over Alleged Fraudulent Billing Practices**
Anthem Health Plans of Virginia, Inc., operating as Anthem Blue Cross and Blue Shield, along with Healthkeepers, Inc., has filed a lawsuit against AGS Health, Inc., The Schumacher Group of Louisiana, Inc. (operating as SCP Health), The Schumacher Group of Virginia, Inc., and several emergency medical provider groups affiliated with SCP. The case was filed in the United States District Court for the Western District of Virginia on November 5, 2025.
The plaintiffs accuse the defendants of exploiting the No Surprises Act (NSA) by submitting thousands of ineligible billing disputes to the federal Independent Dispute Resolution (IDR) process. These disputes were allegedly not qualified under federal guidelines due to existing state laws like the Virginia Balance Billing Law. Anthem claims that these actions resulted in millions of dollars in wrongful awards being obtained by the defendants.
The complaint outlines a coordinated scheme involving false attestations and representations about dispute eligibility, strategic submission of massive volumes of IDR disputes to overwhelm the system, and inflated payment offers exceeding commercially reasonable rates. Anthem seeks to end what it describes as an ongoing criminal enterprise violating both federal and state laws.
