Suit Alleges NJ Insurer Intimidated ED Patients

Kane says Horizon's "artificially" low reimbursements are threatening the viability of the only emergency care option in Bayonne, which emerged from bankruptcy in February 2008. He says Horizon hopes to become a for-profit, public company and it is low-balling reimbursements to New Jersey hospitals–half of which are already losing money–to pad its bottom line, making it more attractive to investors.

"Ultimately, Horizon's attacks are not on hospitals, but on the communities they serve," Kane says. "Their relentless assault on patients, doctors and hospitals for the sake of their own profits is a prime reason that New Jersey ranks last in the country for emergency rooms per capita. Neither this hospital nor the people of Bayonne will be bullied by Horizon. BHC filed this case to fight for patients' rights for quality healthcare and hopes that other hospitals will do the same in their conflicts with Horizon."

Joining the BHC suit as a plaintiff is John Godinsky, MD, a Horizon policyholder, who sought emergency treatment at BHC for an irregular heartbeat. While in the hospital, Horizon allegedly told Godinsky and BHC that his stay was denied coverage because Horizon erroneously claimed it was a pre-existing condition. Against physicians' advice, Godinsky left the hospital fearing he'd be saddled with a large bill.