Valley Hospital is a tier 2 Hospital resulting in higher co pays
By Susan K. Livio | NJ Advance Media for NJ.com
on April 04, 2016 at 7:44 PM
TRENTON — Lawmakers took action on a package of bills that would impose tougher state regulations on tiered health plans Monday, sparked by a backlash against Horizon Blue Cross Blue Shield of New Jersey’s new OMNIA products that steer cost-conscious patients to select hospitals.
The Assembly Regulatory Oversight Committee approved four bills that would require more disclosure on how hospitals and doctors are chosen to join tiered networks. State regulators would have to insure hospitals that serve low-income people are included in these networks, which offer consumers the choice of paying less if they use hospitals and doctors in the preferred tier.
When Horizon last fall debuted the two-tiered OMNIA plans and the cost-cutting arrangement it had struck with 36 “tier 1” hospitals, it instantly generated outrage among the hospitals relegated to “tier 2” status. Patients could still use them but would pay higher co-pays and have to meet higher deductibles to do so.