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11 hospital systems sue state over OMNIA approval
Eleven New Jersey hospital systems are going to court to challenge the state's approval of Horizon Blue Cross Blue Shield of New Jersey's controversial new OMNIA insurance plan.
The lawsuit aims to challenge the lack of adequate coverage, as well as the danger to safety-net hospitals if the OMNIA plan succeeds in driving market share away from urban hospitals.
The lawsuit was filed on behalf of Capital Health Regional Medical Center, CentraState Medical Center, Holy Name Medical Center, JFK Medical Center, Kennedy Health, Our Lady of Lourdes, St. Francis Medical Center, St. Luke’s Warren Hospital, Trinitas Regional Medical Center, Valley Health System and Virtua Health.
The tiered OMNIA network, which was announced in September, gives members greater savings at partner hospitals (mostly suburban systems) known as Tier 1, compared with regular, in-network hospitals (including urban systems), which were labeled Tier 2.
Tier 2 hospitals feel spurned by the state’s largest insurer and believe the state’s Department of Banking and Insurance should not have approved the new plan...
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