New Jersey lawmakers want delay, hearing on insurer’s plan to partner with hospitals

Some New Jersey lawmakers are questioning plans by the state’s largest health insurer to create a new partnership with 22 hospitals.Horizon Blue Cross Blue Shield of New Jersey has said hospitals accepted into the OMNIA Alliance will receive higher reimbursements for providing quality low-cost care.

Hospitals excluded from the plan are wondering why they were left out.

And some say the plan would shortchange some areas of the state.

“They’ve created this huge gap and members living in and working outside now are faced with the decision on whether to travel or face huge out-of-pocket costs,” said Vince Costantino,  chief administrative officer at St. Francis Medical Center In Trenton. “Every dollar counts, and we feel that this is just not right.”

Several elected officials are asking the state Insurance Commissioner to delay implementation of the plan.

“One of our concerns is that time is of the essence in this,” said Assemblywoman Elizabeth Muoio, D-Mercer. “In less than two weeks, you’ll have tens of thousands of public employees who will be entering the open enrollment period and will need to possibly make major changes in their health care coverage based on this new plan, the details of which we are still not clear about.”

Assemblyman Reed Gusciora, D-Mercer — who said the plan creates a void in affordable health coverage for Trenton, New Brunswick and other areas — wants to hold a hearing on the matter.

“This is where an insurance company has decided who are the winners and the losers and who will survive and who will die,” he said. “And I think that this is too critical of a step in health care not to have a public airing.”