Navigation Links
Fox Insurance Company Awarded $3.3 Million in Arbitration Against Former Pharmacy Benefit Manager
Date:12/12/2011

NEW YORK, Dec. 12, 2011 /PRNewswire/ -- Fox Insurance Company, a Medicare Part D provider, with offices in New York, NY, announces a judgment in the arbitration between the company and ProCare, its former pharmacy benefit manager, in excess of $3.3 million, following a suit against ProCare based on Fox's allegations of negligence and breach of contract. 

Nathan M. Barotz, chairman of Fox Insurance Company commented: "Fox Insurance is gratified for the judgment in arbitration, as it clearly supports Fox's ongoing assertion that it was ProCare's failure to carry out its duties under its contract with Fox, and not any failure of Fox Insurance Company, that resulted in the improper denial of claims."

The November 22, 2011 arbitration award includes a finding that ProCare breached the Client Services Agreement (CSA) between the companies. ProCare was cited as failing to have software to carry out Fox's instructions (as well as Centers for Medicare & Medicaid Services (CMS) requirements) regarding prior authorization and high cost edits, and incorrectly informing Fox that it had fixed the problems with its software.

Fox had presented evidence that ProCare's claims processing system returned thousands of drug claims to pharmacies with the message that prior authorization was required, when no such requirement was in place – including on certain "protected class" medications that would never have such a designation.  This caused the rejection of thousands of claims. 

Fox also demonstrated that it had repeatedly asked ProCare to upgrade its software in order to satisfy CMS requirements and instructions regarding prior authorization and protected class drugs.  While ProCare had informed Fox that these upgrades had occurred, they had, in fact, not, which may have threatened Fox's standing with CMS. 

These claim denials drove CMS to take action against Fox in 2010, which resulted in the terminatio
'/>"/>

SOURCE Fox Insurance Company
Copyright©2010 PR Newswire.
All rights reserved

Page: 1 2

Related biology technology :

1. USDA Approves Syngenta and John Deere for Broadened Biotechnology Endorsement for Corn Crop Insurance
2. In the Midst of International Economic Crisis, VidaCura Offers a Helping Hand to Those Without Insurance
3. Biotech Endorsement Insurance Discount Expanded to Nebraska, Kansas Growers Planting Corn with HERCULEX XTRA Traits
4. AMERIGROUP Praises Expansion of State Childrens Health Insurance Program (SCHIP)
5. Value-Based Insurance Design: Helping Employers Improve the Value of Health Care
6. American Oriental Bioengineering Announces the Inclusion of 158 Drugs in Chinas National Insurance Catalog
7. China Sky Medical, Inc. Has 30 Medicines that will Be Included in Chinas National Insurance Directory
8. Commercial Insurance Buyers Benefit From Ample Capacity
9. Cord Blood America Says Outreach Program to OB/GYN Nurses, Insurance Case Workers, Paying Significant Dividends
10. Medical Malpractice Insurance Company- Healthcare Providers Insurance Exchange (HPIX) has Expanded its Presence in New Jersey, Opens New Office
11. New ACO Reinsurance Program Launched by Star Line Group, U.S. Advisors and Ascendent Care
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/24/2014)... 24, 2014 Your cell phone ... modeling lithium-ion battery storage capacity. , New research ... theoretical model created at Lawrence Livermore National ... predicts how carbon components will perform as electrodes. ... the urgent need for higher-performance batteries. Several key ...
(Date:7/24/2014)... Three companies from the angelMD network were ... Competition. Out of 700 competition entrants, Chiron Health, Litesprite, ... round. In this round twenty teams are invited to ... mentoring from thought-leaders and medical entrepreneurs from all over ... commitment to the Livestrong vision around the Big C ...
(Date:7/24/2014)... , July 24, 2014 WIRB-Copernicus Group ... regulatory and ethical review services for clinical research, ... Formerly a division of Richmond, VA ... leading biosafety and biosecurity consulting firm in ... addition, WCG,s biosafety division – WCG Biosafety™ – ...
(Date:7/24/2014)... CA (PRWEB) July 24, 2014 ... http://www.draperuniversity.com , is proud to announce that for ... 17 different countries will converge on the Draper ... for an intensive, experiential program focused on entrepreneurship, ... highly selective school, currently running its sixth cohort, ...
Breaking Biology Technology:Getting More Life out of Lithium-ion Batteries 23 angelMD Startups Make Livestrong Big C Semi-finals 2WIRB-Copernicus Group Announces Acquisition of Alliance Biosciences; Executives Join WCG Biosafety Division 2WIRB-Copernicus Group Announces Acquisition of Alliance Biosciences; Executives Join WCG Biosafety Division 3Summer Entrepreneurship Program Kicked Off by Draper University in Silicon Valley 2Summer Entrepreneurship Program Kicked Off by Draper University in Silicon Valley 3
... United States Department of Energy will invest up to ... Centers, including $125 million for a center led by the ... cellulosic ethanol. , ,The Madison bioenergy research facility , ... Center, will operate in collaboration with Michigan State University ...
... In the age of digital everything, print still captures the ... of everything Internet. , ,There's no clearer example than ... when the company was no more than a brief ... on a windy afternoon and Eileen unwound a vision for ...
... Adelante, Atras!* (For a translation, scroll to the end). The ... buyers alike modifying their steps as the Internet changes everything. ... us have adopted at least some of these changes (both ... information, communicate, interact with each other, or buy and sell ...
Cached Biology Technology:UW-Madison to receive $125M for bioenergy research center 2UW-Madison to receive $125M for bioenergy research center 3Blurb shows that print still captures imaginations 2Blurb shows that print still captures imaginations 3Online retailing "tango" is adding some steps 2Online retailing "tango" is adding some steps 3Online retailing "tango" is adding some steps 4Online retailing "tango" is adding some steps 5Online retailing "tango" is adding some steps 6
(Date:7/24/2014)... out of York University shows a surprisingly effective way ... fungus: moose saliva (yes moose saliva). , Published ... inhibits a grassendophyte mutualism" shows that moose and reindeer ... a fungus called epichlo festucae that produces the toxin ... , "Plants have evolved defense mechanisms to protect themselves, ...
(Date:7/24/2014)... have similar counterparts in humans, affect the connections between ... into the hippocampus, an area of the brain that ... creation of memories. The results of the study have ... Brain function depends on the active communication between nerve ... woven together into a dense network where they constantly ...
(Date:7/24/2014)... funded by the New Jersey Recovery Fund and conducted ... Planning and Public Policy at Rutgers University has found ... about the likelihood of community-based rebuilding solutions. Of the ... they were "pessimistic" or "very pessimistic" that the parts ... rebuilt better than they were before the storm; another ...
Breaking Biology News(10 mins):Moose drool inhibits growth of toxic fungus: York U research 2A protein couple controls flow of information into the brain's memory center 2A protein couple controls flow of information into the brain's memory center 3A protein couple controls flow of information into the brain's memory center 4Rutgers study explores attitudes, preferences toward post-Sandy rebuilding 2
... molecular and protein signatures that predict rapid onset of ... transplant. The markers appeared soon after transplant and ... Such early detection of susceptibility to hepatitis C virus-induced ... treatment options after a transplant. Also, because the ...
... charcoal preserved in deeply buried sediments in Egypt,s Nile ... a huge drought 4,200 years ago associated with the ... the pyramid-building time. "Humans have a long history ... Bernhardt, a researcher with the U.S. Geological Survey. "Along ...
... NC Leukemia and lymphoma patients who receive life-saving ... side effects that significantly decrease quality of life, can ... In chronic Graft vs. Host Disease ... and the recipient,s body often cause these immune cells ...
Cached Biology News:Molecular and protein markers discovered for liver transplant failure from hepatitis C 2Molecular and protein markers discovered for liver transplant failure from hepatitis C 3Molecular and protein markers discovered for liver transplant failure from hepatitis C 4Climate and drought lessons from ancient Egypt 2B cell survival holds key to chronic graft vs. host disease 2
... neurons in vesicles called synaptosomes. ... bouton. Synaptosomes may be centrifuged ... cellular debris. Abnormalites in neurotransmitter release ... condtions. Conditions of release may ...
... Detection Systems allow non-radioactive detection of ... systems, biotinylated lysine residues are incorporated ... the need for labeling with [35-S]methionine ... biotinylated lysine is added to the ...
... Series Hybridization chambers with forced convection ... ambient up to 99.9 C / 212 F ... and reproducible results DS controller Timer ... with an accuracy of a tenth of a ...
... microarray data using Asuragens bioinformatics expertise. We ... to extensive data analysis using the most ... in combination with the Gene Expression Profiling ... ,Normalization and basic statistical analysis including publication ...
Biology Products: