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A $33 million class action settlement was reached to resolve a class action lawsuit alleging Horizon Blue Cross Blue Shield of New Jersey unlawfully bundled payment for certain services with payment for Chiropractic Manipulative Therapy (CMT).
If you are a chiropractor who received payment from Horizon Blue Cross Blue Shield of New Jersey between Dec. 15, 2005 and April 10, 2010, you may be entitled to payment from this class action settlement.
If approved, the Horizon Blue Cross Blue Shield of New Jersey settlement will resolve allegations the insurer paid chiropractors only for Chiropractic Manipulative Therapy that they performed on the same day they performed evaluation and management (E/M) services and physical therapy (PT) services for a patient.
The plaintiffs assert that this bundled payment violates New Jersey Law. On April 10, 2010, the New Jersey Department of Banking and Insurance ordered Horizon to cease and desist its bundling practice. Horizon obliged. The plaintiffs seek relief for the bundling practice that allegedly took place between Dec. 16, 2005 and April 10, 2010.
Horizon Blue Cross Blue Shield denies any wrongdoing but it has agreed to pay $33 million to settle the chiropractor payment class action lawsuit.
The Horizon class action settlement was preliminarily approved on June 20, 2016.
Who’s Eligible
Two Classes of chiropractors have been certified in this Horizon class action settlement:
The ERISA Class involves claims that arise under federal law. Class Members of the ERISA Class include “all chiropractors who, during the Class Period, received payment from Horizon pursuant to an employer benefit plan covered by ERISA for CMT services, but were denied payment for E/M and/or PT services provided on the same date as the CMT service.”
The Non-ERISA Class involves claims that arise under New Jersey law. Class Members of the Non-ERISA Class include: “all chiropractors who, during the Class Period, received reimbursement from Horizon pursuant to an employer benefit plan not covered by ERISA for CMT services, but were denied reimbursement for E/M and/or PT services provided on the same date as the CMT service.”
The ERISA Class and Non-ERISA Class both include the following subclasses:
- Chiropractors who were Participating Providers at the time they provided the service, and
- Chiropractors who were Non-Participating Providers at the time they provided the service.
Potential Award
Varies, based on the total claims Class Members submitted to Horizon.
Proof of Purchase
N/A. Payments to Class Members will be based upon claims that were previously submitted to (and denied by) Horizon.
FAQs
Claim Form Deadline
N/A. There is no Claim Form for this class action settlement. Class Members who wish to opt out of the Horizon settlement must submit an exclusion request no later than Sept. 22, 2016.
Case Name
DeMaria, et al. v. Horizon HealthCare Services Inc., et al., Case No. 2:11-cv-07298 (WJM)(MF), in the U.S. District Court for the District of New Jersey
Final Hearing
10/13/2016
Settlement Website
Claims Administrator
DeMaria v. Horizon Settlement Administrator
P.O. Box 4390
Portland, OR 97208-4390
1-877-341-4577
Class Counsel
John W. Leardi
Vincent N. Buttaci
Paul D. Werner
PUTTACI LEARDI & WERNER LLC
William K. Meyer
D. Brian Hufford
Jason Cowart
ZUCKERMAN SPAEDER LLP
Defense Counsel
James P. Flynn
EPSTEIN BECKER & GREEN PC
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One thought on Horizon Blue Cross Blue Shield Chiropractor Class Action Settlement
Checks have now been mailed out to SOME of the class members. The lawyers did not protect everyone in the class. From what I understand, even though they sent me a postcard and had me register, if they didn’t feel as if you were in a narrow guideline of members you were NOT paid. Members who were billing State plans or Union plans were excluded. If they didn’t feel your billing was correct for the PT/Chiro bundled services you were also excluded. I did treat these patients from the class action lawsuit. I did bill Horizon correctly -as I have been for the past 16 years. I feel I was unfairly excluded. I’m sure the 3 fine law firms who ran this circus of a case were paid. THUMBS DOWN!