Court reverses reduction of out-of-network reimbursement rate
WAYNE, N.J., Sept. 5, 2013 /PRNewswire-USNewswire/ -- The New Jersey Society for Clinical Social Work (CSW)/OPEIU Guild 49 has won its legal action against the State Employees Health Benefits Plan (Horizon BCBS) for lowering their rate of reimbursement to out-of-network practitioners in January 2009.
The NJ State Appellate Division has decided that the lowering reimbursement rates by the SHBP and Horizon was done in violation of N.J.S.A.52:14-17.46.7.