New Jersey hospital files motion against Horizon BCBS over tier placement

New Brunswick, N.J.-based Saint Peter's University Hospital filed a motion to supplement its complaint against Horizon Blue Cross Blue Shield of New Jersey's tiered provider network, the Courier News reports.

To control spending, Horizon BCBS of New Jersey's Omnia tiered network health plans offer members reduced prices for using preferred, or Tier 1, medical providers.

Saint Peter's University Hospital is in a pending case against Horizon BCBS concerning its exclusion from Tier 1 designation. (Saint Peter's is a designated Tier 2 hospital.) In Saint Peter's University Hospital's supplement complaint, the hospital claims it was not given the opportunity to join Horizon BCBS' new Medicare Blue Advantage Plan for 2018.

In its complaint, Saint Peter's claims the hospital and its physicians were excluded from the new narrow network plan based solely on its omission from Omnia's Tier 1 network, according to the report.

Horizon BCBS disagreed with the complaint, saying in a release cited by the Courier News: "Horizon will not respond to press releases or other publicity stunts on routine motions in a two-year-old unsuccessful lawsuit. We'll respond in court to actions St. Peter's files, as appropriate."

More articles on payer issues:
Lyft makes nearly 15k medical transports for Cigna members
Narrow-network health plans make up 73% of ACA exchange market
CVS Health-Aetna deal could be reached Monday: 3 things to know

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months