Practice Management Alert

Payer Updates:

NJ payer settles secondary payer suit to the tune of $8 million

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Horizon Blue Cross Blue Shield (BCBS) of New Jersey has agreed, in an out of court settlement, to pay approximately $8 million in restitution. The settlement is the result of State of New Jersey Department of Banking & Insurance class action suit against BCBS that alleged the payer delayed claims payment on claims in which they were a secondary payer to Medicare.

Horizon agreed to reimburse members and physicians for the affected claims, plus 12 percent interest, by Oct. 1, according to American Medical News. The payer will also face a $500,000 state fine.

Although Horizon agreed to the settlement, it did not admit to any wrongdoing. The payer did agree to revise its secondary payer claims processing as well.