Michael Furey was quoted in an article, "An inside look at how Horizon used hospital costs – and quality – in plan to change N.J. health care," which was published on NJ.com and also appeared in the July 29 edition of The Star-Ledger under the headline, "Reports: Horizon Skewed Quality, Costs on New Plan." The article focuses on confidential reports and related documents obtained by Advance Local Media, publisher of The Star-Ledger, in connection with a lawsuit brought by three New Jersey-based hospitals alleging Horizon Blue Cross Blue Shield of New Jersey breached its obligations by limiting its selection of Tier 1 hospitals to the largest hospital systems. The materials, prepared by McKinsey & Company, were developed to help Horizon establish a new line of insurance products called OMNIA, which launched in November 2015. According to the article, the three hospitals involved in the ongoing litigation—CentraState Medical Center, Holy Name Medical Center and Valley Hospital—are losing millions of dollars a year and are at risk of having to cut services or merge to stay afloat.
The article reports that McKinsey had initially recommended hospitals other than the large systems be Horizon's partner hospitals because they provided excellent care at average or less than average cost. The plaintiff hospitals were in this group, according to the report. Horizon, however, rejected the recommendation and requested McKinsey not consider a hospital's cost of care in making recommendations. Horizon claimed, according to the report, that the cost of care would be irrelevant to the value based care plan Horizon wanted to introduce. The plaintiff hospitals argue such reasoning allowed Horizon to pick the largest and most expensive hospitals as its OMNIA Alliance and Tier 1 partners, which had always been Horizon's plan. The Tier 2 hospitals tend to be smaller and less expensive.
Furey, who represents the three plaintiff hospitals, told The Star-Ledger it has been three years since OMNIA made its debut, and yet it appears hospitals are still paid the same old way. He questioned, when does the value pricing begin?
On April 25, Boston attorneys Bill Pezzoni, Jared Ross and Justin Hannan will present on "Understanding Opportunity Zones: Investor Benefits," a program hosted by the Marlborough Economic Development Corporation (MEDC) in conjunction with the City of Marlborough, MA and Day Pitney LLP.
Keith Bensten authored a case comment, "MA District Court Declares the MA Wiretap Statute Unconstitutional Insofar as it Prohibits Recording of Government Officials Performing Their Duties in Public Space," published in the Winter 2019 edition of the Federal Bar Association Massachusetts Chapter Newsletter.
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On March 11, Paul Williams presented at the Connecticut Defense Lawyers Association (CDLA) seminar, "Titans of the Defense," where he discussed tips, strategies and lessons learned from his trial experience.
Elizabeth Sher, chair of the firm's Complex Commercial Litigation business unit, served as co-editor of the 2019 edition of New Jersey Federal Civil Procedure, the leading treatise on federal practice in New Jersey, published by ALM.
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Gary Betensky and Michael Napoleone were featured in a profile, "Day Pitney LLP: Firm Expands to Better Serve South Florida Clients," published in the March issue of The Boca Raton Observer magazine.
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Day Pitney's representation of Walmart is noted in a Law360 article, entitled "Walmart Wins At NJ High Court In Fight Over Medical Terms."
Day Pitney associate Darian Butcher has been elected as Vice President of the Board of Directors of GLBTQ Legal Advocates & Defenders (GLAD).