Saint Peter’s sued Horizon in 2015, accusing the insurer of wrongly excluding it from the top tier in its Omnia plan. Under the Omnia plan, Horizon members who use a “tier 1” provider can save out-of-pocket costs. Members who use “tier 2” providers, the designation Saint Peter’s was given, face higher out-of-pocket costs.
In its lawsuit, Saint Peter’s argued its tier 2 designation would cost the hospital millions of dollars and jeopardize its long-term success, according to NJ.com.
The settlement means Horizon and Saint Peter’s won’t participate in a trial that was set to begin the week of April 5. Details about the settlement weren’t released.
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