NJ Association of Health Plans: Horizon, CarePoint fallout will drive 'predatory pricing'

The split between Jersey City, N.J.-based CarePoint Health's three HudsonValley hospitals and Horizon Blue Cross Blue Shield has sparked a heated response from the New Jersey Association of Health Plans, reports NJBIZ.

The organization criticized the move by saying it dramatically increased the opportunity for patients to receive unexpected and costly medical bills. "The problem of price gouging and surprise billing just got bigger for New Jersey consumers, the state health benefits program, the state treasury and public employees," said New Jersey Association of Health Plans President Wardell Sanders.

Because out-of-network hospitals are not bound by contractual reimbursement terms, these hospitals typically charge insurers for services at a much higher rate. Horizon said that since it parted ways with CarePoint's ChristHospital in Jersey City last year, the hospital has billed the insurer more than $68 million.

"CarePoint's departure from the Horizon network will only exacerbate the challenges of rising healthcare costs for the state and other employers," Mr. Sanders said.

In an official statement Thursday, CarePoint spokesperson Jarrod Bernstein said the decision to drop Horizon was part of a greater financial survival strategy. "Since rescuing our hospitals from bankruptcy when we acquired them, we have invested tens of millions of dollars in technology and programs to care for all that we serve, regardless of their ability to pay," he said.

 

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