Without warning, Horizon Blue Cross dropped its OMNIA plan onto unsuspecting New Jersey consumers, doctors and hospitals. As the largest health insurer in the state, Horizon is fighting hard in court to get its way, but the insurer has gone too far with its controversial OMNIA plan. OMNIA dangerously undermines health care delivery in New Jersey by punishing some of the state's best and highest rated hospitals, including most Catholic institutions, and steering consumers to specific hospitals. But, you can fight back!
That apparently will remain unknown after a state appeals court last week denied opponents of the plan access to the details of Horizon reports and other information explaining why it classified the hospitals the way it did when it launched its Omnia health plan.
We understand that as a private company, Horizon is not held to the same disclosure standards as a public agency. At the same time, the Omnia plan has drawn so much criticism from hospitals left out of the Tier 1 grouping, Horizon could benefit from complete transparency. More important so could the public.
Horizon created its Omnia plan as part of an alliance with several large hospital systems. A key part of the plan was the creation of a two-tiered system of in-network hospitals. Patients benefit from using Tier 1 hospitals by paying lower costs. Hospitals in the top grouping benefit from an increase in patients.