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 November 18, Darian Butcher will co-chair the Massachusetts Bar Association (MBA) webinar, "Current State of Business/Commercial Litigation in the Superior Courts During the COVID-19 Pandemic."
Day Pitney Partner Joy Harmon Sperling will present on a panel entitled "How to Navigate Debt Collection Restrictions, Manage Liquidity Challenges, and Reconcile Opposing Demands from Consumers and Investors as a Servicer," at the 27th American Conference Institute National Forum on Residential Mortgage Regulatory Enforcement and Litigation.
James Rotondo and Andrew Ammirati co-authored the article, "Ohio: 'Control' determines whether Amazon is subject to strict liability," for Westlaw Today.
On September 29, Christopher Droney and Chase Rogers provided appellate advice to the Appellate Advocacy Section of the Connecticut Bar Association. Judge Droney (ret.) and Justice Rogers (ret.) shared insights on the differences between state and federal appellate practice from their unique perspectives as former appellate jurists who are now in private practice.
Day Pitney Attorneys Alfred Marks and Michael Lane co-authored an article, "Spokeo, Inc. v. Robins: An Underutilized Defense Against Claims Brought Under Federal Consumer Finance Statutes," for The Banking Law Journal.
Judge Christopher Droney was quoted in the Connecticut Law Tribune article, "What Are Some ADR Trends Since COVID-19?"
Day Pitney Press Release
Adam Myron, senior counsel resident in Day Pitney's West Palm Beach office, is running for judge in south Florida.
Day Pitney Press Release
On September 10, Day Pitney LLP and Partner Jeffrey Mueller were featured in an article, "Wrestlers Sued the WWE, but Their Lawyer Misbehaved, Facing $500K in Sanctions," published by the Connecticut Law Tribune.