Valley Hospital was the last of seven hospitals that sued Horizon to settle with the insurer. The hospitals accused Horizon of putting them in a less desirable tier of their OMNIA plans.
Valley Hospital officials didn’t disclose the settlement’s financial terms, but said the hospital had not yet been reclassified as tier one.
The tier one designation was supposed to be reserved for high quality facilities, though Horizon selected only the largest hospitals, even when smaller community facilities may have had better quality measures or prices.
The other hospitals included in the lawsuit were Pennington-based Capital Health Hospitals; Freehold-based CentraState medical Center; Holy Name Medical Center in Teaneck; JFK Medical Center in Edison; St. Luke’s Warren Hospital in Phillipsburg and Elizabeth-based Trinitas Regional Medical Center, all in New Jersey.
More articles on payer issues:
2019 Medicare Part A and B deductibles, premiums: 3 things to know
Most common type of state Medicaid breach? Misdirected letters, faxes
Trump administration’s new insurance guidelines for states, employers: 10 things to know
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.