Valley Health latest to settle with Horizon over OMNIA plans

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Valley Health System is the latest plaintiff to settle its lawsuit with Horizon Blue Cross Blue Shield of New Jersey over the insurer’s OMNIA Health Plans.

“Valley Health System is pleased to announce that we have reached an agreement with Horizon that is beneficial to the hundreds of thousands of New Jersey residents Valley serves. The agreement helps ensure Valley’s ability to serve its community for years to come,” said Michael Furey, an attorney who represented Valley Health System in this litigation.

Fuery told  NJBIZ: “We are gratified that, through the terms of this agreement, Horizon and Valley will continue our longstanding relationship, working together to assist our mutual communities to live longer, better and healthier lives.”
Last week, CentraState Healthcare System withdrew as a plaintiff in its lawsuit against Horizon. Holy Name Medical ended its legal dispute with the insurer in June.

Saint Peter’s University is involved in separate litigation suit OMNIA and is actively proceeding with legal action.

All three entities claimed that they were unfairly excluded from Tier 1 status in the OMNIA plans. Horizon’s network plan divides hospitals into two categories: Tier 1 and Tier 2. Critics of the plan allege network physicians are incentivized to use Tier 1 facilities due to the elimination or reduction of co-pays and deductibles at the expense of smaller, independent hospitals. Tier 2 plans have co-pays and deductibles that can be higher than under Tier 1.