Blue Cross Settles Suit Over Flawed Reimbursement Numbers

Law360, New York (November 14, 2013, 5:25 PM EST) -- Horizon Blue Cross Blue Shield of New Jersey Inc. settled a class action Wednesday that accused the insurer of under-reimbursing health plan subscribers for out-of-network services, agreeing to stop using a database that produced allegedly flawed calculations and to pay up to $2.5 million in attorneys’ fees.

According to a proposed settlement filed in the District of New Jersey, Horizon will stop using the Ingenix database to calculate claims for covered services provided by out-of-network providers. The company will also discontinue use of its “Top of...
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