Judge Finds Insurer’s Payments For Spine Surgery Complied With Plan Provisions

Mealey's (October 3, 2017, 10:22 AM EDT) -- NEWARK, N.J. — Because an insurer appears to have paid a provider 150 percent of the Medicare rate for his services in compliance with plan provisions, the medical professional’s Employee Retirement Income Security Act claim fails, a federal judge in New Jersey held Sept. 13 in granting summary judgment (Professional Orthopaedic Associates P.A., et al. v. Horizon Blue Cross Blue Shield of New Jersey, No. 14-4731, D. N.J.)....

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