NEW YORK (Legal Newsline) — New York Attorney General Eric T. Schneiderman announced Feb. 23 that Oxford Health Plans (NY) and Oxford Health Insurance Inc. (together, “Oxford”),have  agreed to provide refunds to hundreds of small group plan members in New York State after allegedly improperly denying coverage of infusion services.


“Infusion services are vital to patients’ health care. Yet Oxford’s failure to provide the proper coverage adversely affected many New Yorkers with serious medical conditions,” Schneiderman said. “Health plans must take responsibility for promptly identifying and correcting errors that result in improper denials to New Yorkers, who rely on their insurance companies for critical medical care.”


Oxford acknowledged its error in denying coverage and agreed to refund 2,587 claims totaling about $500,000. The company committed to mailing letters to affected members, explaining the situation and notifying them how they can receive refunds. Oxford will also pay a $35,000 penalty to the state.


Handling the case for New York was assistant attorney general Adrienne Lawston of the Health Care Bureau, which is led by bureau chief Lisa Landau. The Health Care Bureau is part of the Social Justice Division.

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