N.J. ASCs to Receive $22M and Increased Reimbursement Rates After Horizon BCBS Settlement

Horizon Blue Cross Blue Shield of New Jersey has settled a lawsuit with approximately 130 ASCs in New Jersey for $22 million and an increase in reimbursement rates between 2011-2013, according to a joint press release from Horizon and law firms involved in the lawsuit.

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The ASCs had filed a lawsuit claiming Horizon failed to properly reimburse them for out-of-network charges pertaining to treatment of Horizon subscribers.

Horizon has also agreed to retroactively adjust claims from the ASCs for services rendered in 2009 and undergo several business reforms which will “provide significant value to the surgery centers,” according to the release.

The settlement is subject to final approval from the United States District Court in Newark, which is expected by the end of 2010.

View the news release on the New Jersey ASC settlement (pdf).

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