Atrium Health Sued for Alleged Breach of Medicare Program Contract

Atrium Health is facing a lawsuit from ApexHealth, which alleges that Atrium breached a contract to support a new Medicare Advantage program. Filed in Mecklenburg County, North Carolina, the case highlights that ApexHealth incurred $62 million in losses due to Atrium’s failure to fulfill its obligations under the agreement. The contract, established in May 2021, required Atrium to act as the primary provider within the Carolinas for the Medicare Advantage plan.

According to ApexHealth, Atrium failed to provide necessary support, hindering marketing efforts and prioritizing its own financial benefits over the contractual duties. This lack of cooperation allegedly resulted in a significant shortfall in enrollment, with fewer than 200 members joining the plan. ApexHealth is seeking compensation for these losses and future earnings.

Atrium Health, a major nonprofit health system serving about 6 million patients, has until July 29 to respond to the lawsuit following a judge-approved extension. Neither Atrium nor ApexHealth has commented on the matter as reported by The Charlotte Observer.