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TexasTowelie

(112,065 posts)
Tue Jul 25, 2017, 05:16 AM Jul 2017

New Jersey Supreme Court allows hospitals to see secret Horizon report

Hospitals excluded from Horizon Blue Cross Blue Shield of New Jersey's preferred list have won the right to see a secret report containing the selection criteria and the scores they received.

The hospitals argue the report will show that Horizon had other considerations besides health care quality when it grouped hospitals as "Tier 1" and "Tier 2" when it created a lower-cost health plan.

The New Jersey Supreme Court ruled Monday in favor of four hospitals – Holy Name Medical Center in Teaneck, The Valley Hospital in Ridgewood, CentraState Medical Center in Freehold and St. Peter's University Hospital in New Brunswick – on one aspect of their long-running legal challenge to Horizon's Omnia plan.

It was a small victory about evidence in the case, in which the hospitals argue that Horizon breached its contract with them and damaged their reputations by excluding them from the preferred tier.

Read more: http://www.northjersey.com/story/news/health/2017/07/24/new-jersey-supreme-court-allows-hospitals-see-secret-horizon-report/505487001/

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