ATTN: ALL INDIVIDUAL DENTISTS OR DENTIST GROUPS WHO PROVIDED SERVICES TO ANY PERSON WHO WAS A SUBSCRIBER OF, OR WAS INSURED BY, HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY (“HORIZON”) AT ANY TIME BETWEEN MAY 26, 1999 THROUGH APRIL 13, 2012
(THE “CLASS PERIOD”).
The purpose of this website is to inform you of a preliminarily approved settlement of two lawsuits consolidated for the purposes of settlement (the “Action”) involving Horizon Blue Cross Blue Shield of New Jersey. The Action, pending in the Superior Court of New Jersey – Essex County (the “Court”), alleges that between May 26, 1999 and the present, Horizon committed statutory and regulatory violations of the New Jersey prompt payment laws, known as Prompt Payment Act and the HINT Act and that Horizon breached its agreements with participating provider dentists by engaging in improper conduct, including alleged improper “bundling” and “downcoding” of claims, rejection of code “modifiers,” and failure to pay according to fee schedules. Horizon denies the allegations. The Court has not decided whether the Class or Horizon is right. The Representative Plaintiff, Michael H. Kirsch, DDS and his attorneys, Eric D. Katz and the law firm of Mazie Slater Katz & Freeman (“Class Counsel”) have concluded that the Settlement is in the best interests of the Settlement Class members.
In a class action lawsuit, one or more persons sue on behalf of other people who have similar claims. These persons, acting as class representatives, assert claims against a defendant on behalf of themselves and all other class members. A class action allows a court to resolve the claims of all the class members at the same time. Any class member who does not file a timely request to opt-out to be excluded from the class will be bound by the final judgment entered in the case, and may not file his or her own lawsuit over the same claims that were resolved in the class action. In this Action, Dr. Kirsch is the class representative and Horizon is the defendant.
On April 13, 2012, the Court authorized notice to be sent to all individual Dentists and Dentist Groups, regardless of specialty and network status, who submitted at least one claim for reimbursement in compliance with Horizon’s criteria and requirements for providing dental services eligible for coverage under a Horizon Commercial Benefit Plan to any person who, at the time such services were provided, was a Plan Member and was eligible for coverage of the services represented by such claim, which services were rendered at any time during the Class Period.
The Court has appointed Eric D. Katz and the law firm of Mazie Slater Katz & Freeman, LLC to serve as Class Counsel to represent the Settlement Class in the Action. Dr. Kirsch, Class Counsel and Horizon entered into a proposed Settlement Agreement (also referred to as the “Agreement” or “Settlement”). On April 13, 2012, the Court preliminarily approved the Settlement and authorized a notice to be sent to all class members about it. The Court has scheduled a hearing to consider the fairness, reasonableness and adequacy of the Settlement, together with certain other matters, to be held on July 23, 2012 at 10:00 a.m., before the Honorable Paul J. Vichness, J.S.C. at Essex County Superior Court, Historic Courthouse, 470 Dr. Martin Luther King, Jr. Boulevard, 4th Floor, Newark, New Jersey 07102, (the “Settlement Hearing”). Please note that the Court may adjourn the Settlement Hearing without further notice to Class Members.