Class-action lawsuit filed in Passaic County arose when the hospital told Horizon it would not continue another year with an increase of less than 1 percent, which it has received since 2009
The Horizon Blue Cross Blue Shield of New Jersey blimp in a file photo.PATERSON — A network of doctors at St. Joseph’s Regional Medical Center sued the Horizon Blue Cross Blue Shield of New Jersey today, claiming the insurance giant was dropping them in an effort to gain leverage in a rate dispute with the Paterson hospital.
A Horizon spokesman said doctors were notified that they would be dropped from a list of in-network providers after hospital executives demanded a 50 percent rate increase for services.
When the insurer refused to grant the increase, the hospital notified Horizon that it sever its contract by the end of the year.
The class-action lawsuit filed in Passaic County arose when the hospital told Horizon it would not continue another year with an increase of less than 1 percent, which it has received since 2009, according to Sean A. Smith, an attorney for the doctors.
Dr. Eileen Clifford, who is a nun as well as the plaintiff in the lawsuit, said Horizon told her to obtain hospital privileges elsewhere or she would be dropped from its in-network list of medical providers.
"The only conclusion that I can draw from Horizon’s correspondence is that Horizon terminated me from its network as leverage in its very public contract negotiations with St. Joseph’s Healthcare System,’’ Clifford said in a statement.
She said she was "appalled at Horizon’s tactics – they are hurting my patients, my practice, and needlessly disrupting the community with their actions."
A spokesman for Horizon, Tom Vincz, said the hospital’s claim was inaccurate.
"Horizon Blue Cross Blue Shield of New Jersey refused such unreasonable demands, particularly in this difficult economy, since they would only work to increase premiums on our customers," Vincz said.
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