According to the suit, Horizon sent couriers to members in the Bayonne hospital or emergency department, telling them that they would incur expensive medical bills if they didn’t transfer out of the hospital, which is not in Horizon’s network. Officials from Bayonne said in the report that this procedure violated state laws and endangered patients’ health.
Horizon says that it has not done anything that is “improper” and that it is obligated to inform members if they will have high medical bills, according to the report.
Horizon recently applied to become a for-profit corporation, and Bayonne says in the suit that Horizon is putting this move ahead of what is best for patients. Additionally, Bayonne claims that Horizon arbitrarily denied coverage to patients at the hospital and has not paid claims since last month, which has cost the hospital around $4.1 million, according to the report.
Although Bayonne is out-of-network, patients who use Bayonne’s or other out-of-network hospitals’ emergency departments will be covered under state law. Horizon has encouraged its members not to use Bayonne’s ER, and as it is the city’s only hospital, Bayonne officials say this could endanger lives, according to the report.
Read the Star-Ledger’s report on the Bayonne/Horizon lawsuit.
Read Bayonne’s complaint against Horizon BCBS (pdf).
