Community members breathed a sigh of relief when Bayonne (N.J.) Medical Center and Horizon Blue Cross Blue Shield of New Jersey reached an agreement last month that would keep the hospital in-network for plan members, but concerns have since surfaced over the decision to not include members of Horizon's managed Medicaid plan, NJ Health in the agreement, according to a New Jersey Real-Time News report.
If Bayonne successfully acquires Hoboken (N.J.) University Medical Center (its owners recently bid on the hospital) and enters into a similar contract with Horizon BCBS for that facility, roughly 1,000 Medicaid recipients enrolled in NJ Health who use the two facilities would be forced to find other providers, according to the report. The hospitals would still be required to treat Medicaid patients on an emergency basis, but would not be required to manage care of patients on the managed plan.
The decision to exclude Medicaid managed care patients drew criticism from state state Sen. Joe Vitale (D-Middlesex). "For these prospective buyers, its [sic] about maximizing profits, not services," he said in the report.
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If Bayonne successfully acquires Hoboken (N.J.) University Medical Center (its owners recently bid on the hospital) and enters into a similar contract with Horizon BCBS for that facility, roughly 1,000 Medicaid recipients enrolled in NJ Health who use the two facilities would be forced to find other providers, according to the report. The hospitals would still be required to treat Medicaid patients on an emergency basis, but would not be required to manage care of patients on the managed plan.
The decision to exclude Medicaid managed care patients drew criticism from state state Sen. Joe Vitale (D-Middlesex). "For these prospective buyers, its [sic] about maximizing profits, not services," he said in the report.
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Horizon Blue Cross Files Two Lawsuits Against New Jersey Hospitals for Out-of-Network, Fraudulent Billing Practices