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 12, Naju Lathia will be speaking on a panel called "Tips from Young Lawyers: What they Need to Succeed," at the New Jersey Defense Association's 9th Annual Women and the Law Seminar.
Jonathan Handler and Sylvia-Rebecca Gutiérrez co-authored an article, "Geographic Information Systems For Environmental Litigation," published by Bloomberg Environment's Environment & Energy Report.
Chase Rogers, former Chief Justice of the Connecticut Supreme Court, served as faculty at the New Appellate Judges Seminar, sponsored by the Institute of Judicial Administration (IJA) at New York University School of Law from July 15 – 20 in New York City.
Day Pitney Alert
On May 31, Michael Furey will be speaking at "Commercial Litigation from the Masters," a program being presented by the New Jersey Institute for Continuing Legal Education (NJICLE) and being held at the New Jersey Law Center in New Brunswick, NJ.
Day Pitney associate Darian Butcher has been elected as Vice President of the Board of Directors of GLBTQ Legal Advocates & Defenders (GLAD).
On October 29, Tom Goldberg, Day Pitney's Managing Partner, was elected to the Board of the Federal Bar Foundation and to the position of Secretary at its annual meeting.
Day Pitney Press Release
Day Pitney LLP, led by partner Michael Furey, is representing a major retailer in connection with a personal injury case of first impression that is pending in the Supreme Court of New Jersey.
Day Pitney Press Release