Navigation Links
Blue Cross and Blue Shield Sued by Health Care Providers for Abusive Practices

NEW YORK, Sept. 11 /PRNewswire-USNewswire/ -- The NY Chiropractic Council (the "Council") as well as the Pennsylvania Chiropractic Association ("PCA"), the Association of New Jersey Chiropractors ("ANJC"), fourteen individual chiropractors and one occupational therapist, located around the country, have sued as the class representatives of the putative class.

Pomerantz Haudek Grossman & Gross LLP and co-counsel Buttaci & Leardi, LLC, have filed a class action lawsuit against the Blue Cross Blue Shield Association ("BCBSA") and a number of state BCBS entities. The suit alleges that BCBSA and its entities violate the Employee Retirement Income Security Act of 1974 "ERISA". The suit challenges the Defendants' abusive practices in using post-payment audits and reviews, and improper repayment demands, to pressure providers to repay substantial sums that have previously properly been paid as health insurance benefits for services provided to BCBS subscribers.

The action alleges that the post-payment audit and review process as applied by the various named BCBS Entities violates the Employee Retirement Income Security Act of 1974 ("ERISA"), in that its repayment demands are retroactive determinations that particular services are not covered under the terms of the BCBS health care plans, but without proper appeal or other protections otherwise available under ERISA for both self-funded and fully insured health care plans offered through private employers. The complaint further alleges that the post-payment audit and review process, as well as the forced withholds of unrelated benefit payments to offset alleged prior overpayments, violate the Racketeer Influenced and Corrupt Organizations Act ("RICO").

The PCA, the Council and the ANJC are participating in the action in an associational capacity on behalf of their members. Dr. John LaMonica, Insurance Chair of the Council, adds that "this action is an important step by the chiropractic profession to fight back against the egregious actions being taken by BCBS against our members." The Council and the ANJC had previously joined in a class action recently filed against Aetna, Inc. for similar post-payment audit practices.

In the complaint, plaintiffs allege that, as a means to maximize its profits, the BCBS Entities are using its post-payment audit and review process to make retroactive adverse benefit determinations whereby they demand that providers repay funds they had previously received for providing services to BCBS subscribers. "In essence," says plaintiffs' counsel Dr. Brian Hufford of Pomerantz Haudek, "the BCBS Entities are alleging overpayments and then just taking the money from the providers, without valid due process protections. We believe this is a blatant violation of law."

Pomerantz Haudek, which has offices in New York, Chicago, Washington, D.C., Columbus, Ohio and the San Francisco Bay area, is acknowledged as one of the premier plaintiff class action firms.

Buttaci & Leardi, based in Princeton, New Jersey, has a dynamic national health care practice, representing licensed health care providers, group practices and other provider-related entities throughout the country. It has extensive experience representing providers in challenging post-payment audits, including those pursued by Aetna, and has obtained tremendous success on behalf of its clients.

For more information regarding this lawsuit log onto, email or call 1-(800) 496-6922.

The NY Chiropractic Council represents Doctors of Chiropractic in NY State and has a mission that states: "to direct people to the realization that healing comes from within; and that ultimately the promotion of health and wellness is superior to the treatment of disease."

SOURCE New York Chiropractic Council
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Breast cancer prevention practices vary across Canada
2. S.C. BlueCross Creates Corporate Planning Unit, Promotes Davis to Vice President
3. S.C. BlueCross to Integrate Care Management with Personal Health Record in Real Time
4. BlueCare(R) Family Plan, a HUSKY Health Plan from Anthem Blue Cross and Blue Shield in Connecticut, Raises Awareness, Funds and Diapers for New Haven Diaper Bank
5. Blue Cross Blue Shield of Michigan Corrects News Story about Drug Coverage Announcement
6. Independence Blue Cross Makes Music for Members Ears
7. Hundreds of RNs from Across U.S. and World to Join California Nurses Association/NNOC National Convention
8. Sean P. McLaughlin Joins Red Cross as Chief of Operations Support
9. Harvard Researchers Select S.C. BlueCross for National Honor
10. Highmark Blue Cross Blue Shield Introduces New Health Plan Comparison Tool for Consumers
11. Blue Cross and Blue Shield Initiatives Recognized for Increasing Patient Safety and Efficiency
Post Your Comments:
(Date:6/27/2016)... ... June 27, 2016 , ... ... strategic partnership with Connance, a healthcare industry leader providing predictive analytics to ... technology combine to provide health systems, hospitals and ambulatory surgical centers with ...
(Date:6/26/2016)... Michigan (PRWEB) , ... June 26, 2016 , ... On ... as sponsor of the 2016 Cereal Festival and World’s Longest Breakfast Table in Battle ... honor of the city’s history as home to some of the world’s leading providers ...
(Date:6/26/2016)... , ... June 26, 2016 , ... ... once they have been diagnosed with endometriosis. These women need a treatment plan ... require a comprehensive approach that can help for preservation of fertility and ultimately ...
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture animations, ... Christina Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package transforms ... Final Cut Pro X . Simply select a ProHand generator and drag it above ...
(Date:6/25/2016)... ... 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the ... to iHire in recognition of their exemplary accomplishments in worksite health promotion. , The ... Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Any dentist who has made an implant supported denture ... of them do not even offer this as a viable ... costs involved. And those who ARE able to offer that ... cost that the majority of today,s patients would not be ... , founder of Dental Evolutions Inc. and inventor of Implanova ...
(Date:6/23/2016)... LOS ANGELES , June 23, 2016 /PRNewswire/ ... (NASDAQ: CAPR ), a biotechnology company ... first-in-class therapeutics, today announced that patient enrollment in ... progrEssion in Duchenne) has exceeded 50% of its ... its enrollment in the third quarter of 2016, ...
(Date:6/23/2016)... BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of Astellas Farma Colombia ... the company,s second affiliate in Latin America . ... ... Farma Colombia ... ...
Breaking Medicine Technology: