Day Pitney's Michael Furey was quoted in an article, "The Valley Hospital, Holy Name
Medical Center win right to see report on tiered insurance
plan," in The Record. Furey and Dennis LaFiura
recently obtained a win for the seven hospital systems in New
Jersey that they are representing in litigation against Horizon
Blue Cross Blue Shield of New Jersey relating to its new,
two-tiered health plan called Omnia.
The hospitals, which are in the plan's second tier, will now
have access to the report prepared by McKinsey & Co. for
Horizon Blue Cross Blue Shield of New Jersey. The report, which was
not public, evaluated hospitals in the Horizon statewide network
and projected how many patients would stop going to Tier 2
hospitals and shift to Tier 1 hospitals. The hospitals are
contending that Omnia breaches their contracts with Horizon and
violates their other rights. They claim the marketing of the Omnia
plan makes them look inferior to those hospitals in the first tier,
with the stated purpose of the plan being to shift customers from
Tier 2 to Tier 1 hospitals. The hospitals are seeking various forms
of relief, including a halt to further misleading advertising.
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