Capital Health System, Inc., et al. v. Horizon Healthcare Services, Inc.

Date Filed: December 10, 2015
Status: Pending
District Court: Superior Court of New Jersey, Chancery Division, Bergen County – Case No. BER-C-369-15
Appellate Court: Appellate Division Docket No.: A-2913-15T2; Supreme Court of New Jersey Camden County Case No. 077998
Nature of Suit: Antitrust
Defendant Type: Payer
Plaintiff Type: Private

After Horizon Blue Cross Blue Shield of New Jersey formed the tiered health plan Ominia, which gives discounts on premiums and fees to subscribers opting for care at “Tier 1” as opposed to “Tier 2” hospitals, several hospitals sued over the lack of transparency in the criteria used to decide tier designations. Some of the plaintiffs dropped out of the litigation. A New Jersey appeals court ruled against the remaining plaintiffs in June 2016. In September 2016, the New Jersey Supreme Court denied the plaintiffs’ request for the court to reconsider the case. On July 24, 2017, the NJ Supreme Court reversed the appellate court’s June 2016 decision and remanded it back to the trial court for proceedings.

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