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Case ID: 4935 | Drugs / Medical | 10/17/2006
Doctors have reached a deal to settle their class-action lawsuit claiming New Jersey's largest health maintenance organization shortchanged thousands of physicians.
Under the proposed agreement with Horizon Blue Cross Blue Shield of New Jersey, the HMO agreed "to continue significant business practice improvements," according to a joint statement issued by the doctors and the Newark-based company that was provided Monday by a lawyer for the doctors. The attorney for the doctors, said that the doctors do not get any money under the deal, but that Horizon will pay lawyers' fees. The doctors had charged that Horizon and three other health insurers routinely shortchanged thousands of physicians through late or improperly reduced payments. If approved by a state judge, the deal will end Horizon's involvement in a lawsuit filed in 2002 on behalf of at least 40,000 New Jersey doctors. Also sued were Cigna Healthcare of New Jersey Inc., a part of Cigna Corp., of Philadelphia; United Healthcare of New Jersey Inc., a unit of UnitedHealth Group of Minneapolis; and Oxford Health Plans Inc., of Trumbull, Conn. Since then, the Cigna and United Healthcare cases have become part of other national class-action cases in Florida. The case against Oxford, whose parent company merged with UnitedHealth in 2004, is in arbitration. Horizon, which insures more than 3.2 million people in New Jersey, did not admit any wrongdoing in the settlement, said company spokesman. Horizon is to take several steps, according to the joint statement. These include: -- Making fee schedules for commonly used procedures available to participating physicians by CD-ROM or electronically. --Providing 90 days notice to participating physicians of material changes to its contracts, policies and procedures. -- Allowing participating primary care physicians to close their practices to new patients covered by Horizon. -- Not reducing fees for participating physicians, if at all, more than once a year. -- Not recovering overpayments to physicians more than 18 months after the original payment. -- Not revoking its own determination of medical necessity without evidence of fraud, significant error or a significant change in the condition of a patient prior to service. At Lawcash.com, it is our goal to keep you informed about important legal cases, class actions and settlements. Our lawyers offer free legal evaluations in tort cases, class actions, personal injury, and other lawsuits because we are dedicated to helping you resolve your legal complaints. Other Drugs / Medical Cases of Interest In 2004, more than 500,000 children who were enrolled in Medicaid did not receive preventive medical services. That number included more than 180,000 children under the age of 5. Less than $1 of every $5 of Florida's Medicaid budget was spent on children in 2004, although they made up more than half of people enrolled in Florida Medicaid.
A lawsuit challenging a hospital's $1,133 bill to clip a toenail and run tests has been certified as a class action that could include other patients charged similar fees by the hospital.
Lori Mill is challenging a $418 fee included in the bill for "miscellaneous hospital charges" because she had her toenail clipped to check for fungus at Virginia Mason Medical Center's downtown complex rather than at one of its other clinics. Vinyl Chloride is a highly toxic substance: by the time it can be smelled, it is at levels 3,000 times higher than EPA safety standards allow-- it is associated with degenerative bone disease and fatal cancer. Plant workers, PVC (polyvinyl chloride) fabricators, railroad and transportation workers, and beauticians who worked prior to 1974 are most likely to have been exposed; exposure may also come through contaminated drinking water or living near an area where PVC is manufactured, loaded, or unloaded. If you or a loved one might have been exposed to this highly toxic chemical, please contact Kahn Gauthier for more information. A class action has been filed against Watson Pharmaceuticals Inc. (NYSE: WPI) and certain of its officers and directors by stockholders who purchased the company's common stock between November 2, 1999, and November 13, 2001. The action claims that the defendants violated federal securities laws by issuing a series of material misrepresentations to the market over this time period, thereby artificially inflating the price of the company's securities. A class action has been filed against AstraZeneca PLC (NYSE:AZN), a pharmaceutical company and certain of its officers and directors by stockholders who purchased the company's common stock between April 2nd, 2003 and October 11th, 2004. The action claims that the defendants violated federal securities laws by issuing a series of material misrepresentations to the market over this time period, thereby artificially inflating the price of the company's securities. The stockholders seek to recover compensatory damages for the loss of value of their stock. The parties have reached a tentative $1.25 million settlement in a class action filed against MiniMed, Inc., and certain of its officers and directors by stockholders who held the company's common stock as of July 16, 2001. Persons eligible to participate in the settlement must submit a proof of claim form postmarked no later than September 13, 2004. |
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