Judge Remands Insurance Payment Spat For Clarification Of Methodology

Mealey's (May 3, 2023, 2:34 PM EDT) -- TRENTON, N.J. — An insurance company never referenced the gap methodology it now claims it used in determining an autism-care provider’s reimbursement, leaving the court “at a loss” for how it could conclude that the rate was reasonable, a federal judge in New Jersey said in remanding the Employee Retirement Income Security Act case to the administrator for clarification....