Response Oncology, Inc. v. Blue Cross & Blue Shield of Missouri, 941 S.W.2d 771 (Ct. App. Missouri 1997) – decided March 25, 1997 – Missouri Court of Appeals, Western District – Robert E. Hoskins

I represented the plaintiff, Response Oncology.  This is a tedious case.  The case did not involve ERISA.  Missouri state law governed the relationship between the medical provider and the insurer.  There was not a lot of money at issue in this case.  My client billed approximately $66,000.00 for services it rendered to its patient who was insured through Blue Cross Blue Shield of Missouri.  Blue Cross Blue Shield had actually paid a portion of the charges (approximately $25,000.00) and we were arguing over the balance.  I flew to Columbia, Missouri to try this case and the state court judge ruled with me and my client.  Blue Cross Blue Shield appealed the decision.  I, again, few to Columbia, Missouri to argue and the Missouri Court of Appeals (Western District) reversed the state court judge on one point, but ruled with me on another point that the state court judge had not addressed which balanced the two rulings out.  In the end, I felt as if it was a victory.  The two things I remember most about this case are, first, don’t forget to sign your name to the attorney log when you are directed to do so by the Chief Judge on your panel.  My name does not appear on the decision, although I tried the entire case in the lower court and argued the appeal at the University of Missouri School of Law.  Before the argument, the Chief Judge on the panel nicely directed me to make sure that I signed the log book.  After arguing for a half an hour, the thought “slipped my mind” and I did not sign the log book.  Therefore, my name does not appear on the published opinion as being counsel of record.  Second, if I, as an attorney, feel that a case is convoluted and hypertechnical then it is pretty safe to assume that the court probably feels the same way.  At the end of the decision, the court noted:

“The court makes the following two observations after attempting to wade through the facts of the case at bar:  Blue Cross would be well advised to simplify and reduce to understandable English the contract language with members.  In the same vein, Blue Cross and contract health providers should strive for brevity and simplicity in mutual agreements, and should take the time to tailor contracts to fit unique but predictable situations such as occurred here.” 

I have to say, after handling the case, that I could not more fully agree with the above quoted observation of the Missouri Court of Appeals.  (Click here to view the full published opinion.)