April 9, 2021
7:41 am
Saint Peter’s Healthcare System and Horizon Blue Cross Blue Shield of New Jersey on April 7 announced they will end ongoing litigation over Omnia Health Plans. As a result, Saint Peter’s will become a Tier I facility in Horizon’s OMNIA Health Plans effective May 1, 2021.
For many years, Saint Peter’s and Horizon BCBSNJ have worked closely to provide high-quality, cost-effective care to Horizon members. This settlement accelerates the deployment of value-based care and reimbursement models that are an essential element of OMNIA Health Plans’ success.
The parties issued the following joint statement:
“We are pleased to have reached an agreement settling our legal dispute. Instead of continuing to focus on our differences, we look forward to working together to advance health care quality, affordability and the customer experience. Saint Peter’s and Horizon BCBSNJ will continue our long history of collaboration to further enhance this partners
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St. Peter s Healthcare, Horizon BCBS of New Jersey settle contract dispute
Modern Healthcare Illustration / Getty Images
Saint Peter s Healthcare System and Horizon Blue Cross Blue Shield of New Jersey have settled a years-long contract dispute, the organizations announced Wednesday.
Effective May 1, New Brunswick, N.J.-based St. Peter s will become a Tier 1 facility in Horizon s OMNIA Health Plans, which means members pay the lowest level of cost-sharing for hospital and outpatient surgery services provided by the best doctors and hospitals in Horizon s managed care network. The undisclosed settlement resolves allegations that Saint Peter s University Hospital was illegally excluded from Horizon s top OMNIA plan.
N.J. hospital ends 6-year legal fight with Horizon in deal that could save patients money
Updated Apr 08, 2021;
Saint Peter’s University Hospital and Horizon Blue Cross Blue Shield of New Jersey ended a six-year legal battle and reached a settlement Wednesday that will give patients who use the New Brunswick facility access to less expensive care and gives the hospital preferred status as a top-tier provider.
Arguing it was wrongly excluded from what was then a new line of new discounted insurance plans called OMNIA, Saint Peter’s University Hospital filed a lawsuit in November 2015 to stop Horizon, the dominant insurance carrier in the state, from selling the policies without giving the hospital a chance to participate as a “tier 1″ provider.