Suit Against Oxford Health Plans Removed to Federal Court

On Wednesday, the defendants in a healthcare underpayment case removed the complaint to federal court in the District of New Jersey. The complaint was originally filed in the Superior Court of New Jersey, Passaic County by Gotham City Orthopedics LLC against Oxford Health Plans Inc. as well as affiliated companies and several unknown individuals.

Per the complaint, Gotham is required by law to treat Oxford’s insureds for out-of-network emergency health coverage. From May 2014 through May 2017 Gotham performed emergency medical services to the defendants’ insureds and expected to be paid $476,525.31.  The plaintiff has allegedly only received $45,613.08 from the defendants.

The plaintiff is represented by Brach Eichler LLC. The Instance action is brought for breach of implied contract, breach of covenant of good faith and fair dealing, promissory estoppel, quantum meruit, and violations of New Jersey Regulations governing payment for emergency services rendered by an out-of-network provider.

Gotham is seeking declaratory judgment in their favor for compensatory damages, interest, attorneys’ fees, and any fees the Court deems fit.

Oxford removed the case to federal court under subject-matter jurisdiction, as the case centers on the Employee Retirement Income Security Act (ERISA). They are represented by Stradley Ronon Stevens & Young LLP.