Cross-plan offsetting occurs when a valid payment from one plan is artificially reduced to "offset" an errant overpayment made to the same provider from a different plan.
Back in 2019, an Eighth Circuit Court of Appeals case offered key insight about "cross-plan off-setting." Without directly ruling on the matter, that Appellate Court sharply questioned whether ERISA permitted cross-plan offsetting. Now, a New Jersey District Court has directly held that cross-plan offsetting represents an ERISA fiduciary violation. [Lutz Surgical Partners, PLLC v. Aetna, Inc. 2021 WL 2549343 (D. N.J., June 21, 2021).]
Continue Reading for Free
Register and gain access to:
- Breaking benefits news and analysis, on-site and via our newsletters and custom alerts
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the property casualty insurance and financial advisory markets on our other ALM sites, PropertyCasualty360 and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.