Post by Logan on Jun 24, 2016 9:59:27 GMT -6
Horizon Blue Cross Blue Shield doesn't have to reveal criteria for tiered insurance plan, court says
The state’s largest insurer doesn’t have to reveal exactly how it classed hospitals into preferred and non-preferred tiers when it launched the Omnia health plans last year, an Appellate Court panel said Thursday.
The ruling appeared to dim the prospects for a victory by the opposing hospitals — including Holy Name Medical Center in Teaneck and The Valley Hospital in Ridgewood —in their case against the Omnia plans, by saying their arguments “rest on the slenderest of reeds.”
It was the second major loss in court this month for the hospitals opposed to Horizon Blue Cross Blue Shield of New Jersey and its implementation of the new plans. But Steven M. Goldman, the attorney representing them, vowed to appeal the decision to the state Supreme Court. The hospitals “remain committed to unraveling the unnecessary mystery surrounding Omnia,” said Goldman, a former state insurance commissioner.
“This case isn’t over,” said Michael Maron, Holy Name’s president and CEO. “This was a little detour about what has to be revealed in court,” he said, adding that the underlying case — about whether Horizon breached its contracts with the Tier 2 hospitals — is still being fought.
Read more: www.northjersey.com/news/horizon-blue-cross-blue-shield-doesn-t-have-to-reveal-criteria-for-tiered-insurance-plan-court-says-1.1621003
The state’s largest insurer doesn’t have to reveal exactly how it classed hospitals into preferred and non-preferred tiers when it launched the Omnia health plans last year, an Appellate Court panel said Thursday.
The ruling appeared to dim the prospects for a victory by the opposing hospitals — including Holy Name Medical Center in Teaneck and The Valley Hospital in Ridgewood —in their case against the Omnia plans, by saying their arguments “rest on the slenderest of reeds.”
It was the second major loss in court this month for the hospitals opposed to Horizon Blue Cross Blue Shield of New Jersey and its implementation of the new plans. But Steven M. Goldman, the attorney representing them, vowed to appeal the decision to the state Supreme Court. The hospitals “remain committed to unraveling the unnecessary mystery surrounding Omnia,” said Goldman, a former state insurance commissioner.
“This case isn’t over,” said Michael Maron, Holy Name’s president and CEO. “This was a little detour about what has to be revealed in court,” he said, adding that the underlying case — about whether Horizon breached its contracts with the Tier 2 hospitals — is still being fought.
Read more: www.northjersey.com/news/horizon-blue-cross-blue-shield-doesn-t-have-to-reveal-criteria-for-tiered-insurance-plan-court-says-1.1621003