Beginning Jan. 1, Horizon planned to contract with American Specialty Health Network to oversee coverage of its chiropractic, physical therapy, occupational therapy and acupuncture claims. New Jersey chiropractors and others fiercely objected the plan, arguing it would increase improper denial rates. In September, Horizon sued a physician advocacy group after the group urged patients to fight the policy change.
New Jersey’s insurance Commissioner Marlene Caride ultimately rejected the proposal Oct. 11. Horizon and American Specialty Health are able to resubmit a new contract, however Horizon said Oct. 17 it would stop pursuing the proposal for now.
American Specialty Health has been involved in recent legal disputes. In September, the third-party claims processor and Cigna agreed to a $20 million settlement to resolve two lawsuits concerning payment for chiropractic care.
More articles on payers:
CMS sanctions UnitedHealthcare plan: 3 things to know
The 2020 Medicare plans with 5 stars
UnitedHealth posts $5B profit in Q3
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
