Cooperating for better care.

News & Views

N.J. hospital sues insurer for excluding it from discount plan

Share this:


St. Peter’s University Hospital, in New Brunswick, N.J., is suing the state’s largest insurer, Horizon Blue Cross and Blue Shield of New Jersey,  asserting that the hospital was wrongfully excluded from a discount insurance plan called Omnia Health Alliance.

In response, Horizon Public Affairs Director Thomas Rubino said, “It is unfortunate St. Peter’s, one of our long-standing network hospitals, would choose litigation instead of conversation on how we can work together to provide those we both serve with access to lower-cost healthcare.”

Omnia, a two-tier health plan, will provide 15 percent premium discounts to patients who use a Tier 1 facility or physician.  Tier 2 hospitals, including St, Peter’s, do not receive similar discounts.

St. Peter’s asserts that Omnia classified the hospital as Tier 2 without notice and without giving the hospital an opportunity to apply for Tier 1 status.  The hospital is arguing that its contract with Horizon  mandated that St. Peter’s  be  advance notice of the new network and its criteria.

A hospital spokesman says it spends nearly $39 million annually on care for the uninsured, community outreach and its clinic.

Contact Info

(617) 230-4965

Wellesley, Mass