TRENTON – Senate Commerce Chair Nia H. Gill and Senate Health Chair Joseph F. Vitale today called on the state’s acting attorney general to investigate Horizon’s new OMNIA Alliance and tiered benefits system and to establish a permanent oversight mechanism for the program. The senators issued the following joint statement after hearing from Horizon, experts and various stakeholders at today’s hearing of the Senate Commerce and Health, Human Services and Senior Citizens committees:
“Our hearing revealed that Horizon misrepresented to the public and legislators the makeup of the widely-publicized OMNIA Alliance and failed to disclose all participating providers within the tiered system. In addition, the Department of Banking and Insurance may have violated state law and its own regulations by approving the tiered plans even though they did not meet the established requirements.
“The attorney general must immediately intervene and establish a permanent oversight mechanism for the process to ensure fairness, transparency and consistency in the hospital and physician ratings and a focus on quality of care. Precedent for this was established in New York under then-Attorney General Cuomo in response to a tiered system in that state.
“With the introduction of this plan in New Jersey under an extremely flawed process, it is critical that we act. Failure to do so could compromise the quality of care patients receive and the health of hospitals throughout the state. Strong oversight and accountability of this program is vital to ensuring our residents are protected.”