A Philadelphia judge has put a halt to a possible class action lawsuit against Independence Blue Cross (IBC) and its subsidiaries by denying class certification, the first hurdle to such action.

The group of health care subscribers and providers -- led by Steven C. Eisen, D.C. and other chiropractors -- had charged IBC with discriminating against chiropractic and "rubber stamping" chiropractic claims as not medically necessary.

According to an analysis by Jennifer Batchelor in The Legal Intelligencer, Judge John W. Herron found that the actions by Blue Cross were "not sufficiently typical for class action certification and did not present predominating common questions of fact and law because each plaintiff's claim hinged on an individual determination of medical necessity."

Dr. Eisen said the decision was a "great disappointment," and all the more frustrating because the judge used the same arguments as the plaintiffs.

"The judge said that cases of medical necessity must be determined on a case-by-case basis and therefore a class action suit was not a fair and appropriate way to litigate this. The whole point of our suit was that they use a cookbook approach -- which we documented -- and don't approve care on a case-by-case basis," Eisen explained.

"Our attorneys said it was simply a wrong and bad decision," he added. "We will appeal, so it's not over yet. It was a setback but I'm still optimistic we will prevail."

In the Intelligencer article, the plaintiffs' attorney D. Brian Hufford of New York stated: "We thought that we had demonstrated that there are systemic policies and procedures that had been adopted by [Blue Cross] which improperly denied coverage for chiropractic care or alternatively led to refusals to reimburse chiropractors for medically necessary care. Unfortunately, the court saw it a different way."