Horizon Blues lawsuit gets class-action status in N.J.

NEWS IN BRIEF — Posted Aug. 23, 2004

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New Jersey physicians who treat patients insured through Horizon Blue Cross Blue Shield of New Jersey can be part of a class-action lawsuit alleging that the company violated prompt payment laws, a New Jersey state court judge ruled in late July. The class includes an estimated 40,000-plus physicians.

The judge certified a second class of physicians that includes about 3,000 doctors who alleged that capitated payments from the health plan were delayed or otherwise paid inappropriately. Pediatricians were certified as a third class who can go forward with allegations that the insurer downcoded and bundled claims and failed to recognize modifiers. That class includes about 2,000 doctors. Other specialties will be allowed to apply for injunctive relief, the judge ruled.

Clifton, N.J., pediatrician John Sutter, MD, filed the proposed class-action lawsuit in April 2002.

"We look forward to immediately adding additional physician specialties as class representatives and moving this case along swiftly to conclusion and obtaining the best possible relief for our state's physicians," said Eric D. Katz, Dr. Sutter's attorney.

Note: This item originally appeared at

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