N.J. senators ask FTC to investigate Horizon's controversial tiered network

Controversy continues to swirl in the Garden State over Horizon Blue Cross Blue Shield of New Jersey's choice of preferred hospitals for its new tiered-network plan. In response to providers' criticism of the insurer's new Omnia Health Alliance, two Democratic state senators, Nia Gill and Joseph Vitale, have asked the Federal Trade Commission to examine the plans' legality, NJ.com reports.

The senators want an outside review, they say, because "a number of the relevant state regulatory agencies have either declined to participate or have engaged in a flawed process of oversight" of Omnia. Acting state Attorney General John Hoffman, meanwhile, has told the senators that he will not investigate Omnia because of a conflict of interest.

Horizon's CEO Bob Marino recently told FierceHealthPayer in an interview that the insurer used primarily objective metrics to choose its Tier 1 providers, including service offerings and consumer preference data. The Omnia alliance, he says, is the insurer's way of responding to high healthcare costs in the state. Article

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