NJ hospitals appeal state approval of tiered health care group

A dozen New Jersey medical groups are appealing the state’s approval of a new alliance formed by the state’s largest health insurer.

The groups, including Capital Health Regional Medical Center and Virtua Health, filed their appeal against the Department of Banking and Insurance Thursday.

The hospital group says the department approved Horizon Blue Cross Blue Shield’s OMNIA Health Alliance without holding public hearings.

The alliance uses a tiered network and is billed as a money-saving way to offer health care.

The appealing hospitals say the alliance is “demoting” them to Tier 2 and that Tier 1 hospitals will likely get more patients because of lower costs.

Horizon public affairs director Thomas Rubino called the appeal “unfortunate.”

A banking department spokesman has not replied to a message seeking comment.

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