Tuesday, April 26, 2016

Horizon on hospital contract termination: Hold on a second!

An announcement from Horizon Blue Cross Blue Shield of New Jersey:

CarePoint Health Terminated Bayonne Hospital and Hoboken University Medical Center Contracts With Horizon

(Newark, NJ, April 26, 2016) – Two hospitals owned by the for-profit CarePoint Health company, Bayonne Hospital and Hoboken University Medical Center, will end their longstanding relationship with Horizon Blue Cross Blue Shield New Jersey (Horizon BCBSNJ) in the next 45 days. CarePoint Health terminated, without cause, both contracts and refused reimbursement increases offered by Horizon BCBSNJ, the state’s largest health insurer.

CarePoint Health withdrew Christ Hospital in Jersey City from Horizon BCBSNJ’s network on June 1, 2015. CarePoint is terminating Bayonne’s in-network status effective May 1, 2016 and Hoboken University Medical Center effective June 1, 2016.  As of that date, all of CarePoint Health’s facilities and providers will be out-of-network.

In accordance with New Jersey state regulations, Horizon BCBSNJ has sent notices to members in the Hudson County area advising that the facilities will no longer be in Horizon BCBSNJ’s hospital network.  Horizon BCBSNJ members will be subject to higher out-of pocket costs when using the CarePoint facilities as a result. 

“There has been some confusion about who is responsible for the termination, but the facts are clear: CarePoint Health notified us last year that they were exercising their right to terminate the contract without cause,” said Kevin McArdle, Public Affairs Manager for Horizon BCBSNJ. “We have put forward a number of reasonable offers to CarePoint and continue to hope that they will return to the negotiating table,” McArdle added.

Horizon BCNSNJ is committed to lowering healthcare costs for New Jersey residents and remains open to discuss an acceptable rate structure with CarePoint.

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 www.HorizonBlue.com. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association serving more than 3.8 million members.