A federal judge in Newark has granted final approval to a $160 million settlement on behalf of out-of-network ambulatory surgical centers which claimed the insurance company’s policies did not provide adequate reimbursement for services rendered.
U.S. District Judge Kevin McNulty approved the settlement terms and granted $9 million in legal fees on Friday, ending a 12-year litigation saga over claims that New Jersey’s largest health insurer shortchanged ambulatory surgical centers outside its provider network.
The suit that just settled, Edwards v. Horizon Blue Cross...
A group of more than 180 ASCs requested a federal court's final approval of a $4 million settlement with Horizon Blue Cross Blue Shield of New Jersey, Law360 reports.
Here are six insights:
1. The suit, which was initiated 13 years ago regarding Horizon's out-of-network reimbursement practices, accuses the payer of making improperly low reimbursements on medical claims in violation of the Employee Retirement Income Security Act. The suit includes two subclasses — Navigant and the Student Employee Health Plan.
2. The centers have already received more than $150 million...
TRENTON -- Gov. Chris Christie's battle with Horizon Blue Cross Blue Shield of New Jersey to give up $300 million of its reserves to the state intensified Wednesday when the governor vilified the insurer for getting slapped with $16 million in fines from the state over a period of nine months.
In a hastily called news conference, Christie accused Horizon of having "brazenly failed its members" covered by Medicaid and renewed his push for legislation he argued would add more accountability and transparency within the insurer.