Horizon Calls Unanimous Appellate Court Ruling “A Win for Consumers”

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Horizon Blue Cross Blue Shield of New Jersey declared today’s Appellate Court ruling a victory for consumers seeking relief from the crushing burden of sky-high health care costs.

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The Appellate Court’s ruling is another in a long line of wins for the consumers of New Jersey. The status quo is simply not sustainable and we should all be working together to address the cost.

Horizon Blue Cross Blue Shield of New Jersey declared today’s Appellate Court ruling a victory for consumers seeking relief from the crushing burden of sky-high health care costs, Superior Court of New Jersey Appellate Div., Docket No. A2913-15T2 & A2929-15T2.

In their ruling (http://www.judiciary.state.nj.us/opinions/a2913-15a2929-15.pdf) the court provided some analysis of the contracts between Horizon and the hospitals who filed the suit and found, “on its face, the plain language of the Agreements does not appear to support the hospitals’ claims that Horizon was required to place them in Tier 1 of the new program or give them an opportunity to apply for inclusion in that specific tier.” (pp 25-26)

Horizon BCBSNJ Chairman and CEO Robert A. Marino reacted to the ruling saying, “The Appellate Court’s ruling is another in a long line of wins for the consumers of New Jersey,” said Robert A. Marino, Chairman and CEO of Horizon BCBSNJ. “The status quo is simply not sustainable and we should all be working together to address the cost- crisis in health care. Horizon’s goal is, and will always be, to provide high quality, affordable health coverage to New Jerseyans who are demanding, and who deserve, nothing less.”

The court sided with Horizon in issuing other notable findings:

  •     “The Agreements do not require Horizon to treat all hospitals the same in terms of future products.” (Page 26)
  •     “Therefore, based on the plain language of the Agreements, the hospitals’ claims appear to rest on the slenderest of reeds.” (Page 27)
  •     “We conclude that the information sought by St. Peter’s and Capital is not relevant to the issues of contract interpretation that dominate this litigation.” (Page 29)
  •     The plaintiff hospitals are not entitled to disclosure of fee schedule information of other hospitals. ( pp 33-34)

Tom Wilson, Horizon BCBSNJ’s Director of Public Affairs added, “The attorneys for these hospitals should apologize to consumers for their failed effort to defend the indefensible, sky-high cost of health care in New Jersey. The high priced lawyers, lobbyists, and PR firms working to obstruct Horizon’s effort to lower the cost of health care are serving no one but themselves.”

About Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer is a tax-paying, not-for-profit health service corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is leading the transformation of health care in New Jersey by working with doctors and hospitals to deliver innovative, patient-centered programs that reward the quality, not quantity, of care patients receive. Learn more at http://www.HorizonBlue.com. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association serving more than 3.8 million members.

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Kevin McArdle
Horizon Healthcare Services, Inc.
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