May 2009
Horizon Blue Cross Blue Shield of New Jersey Files Lawsuit Against Bayonne Medical Center for Fraud
Bayonne Medical Center’s 2009 Aggregate Per Day Charge Totals $29,000
(Newark, NJ, May 14, 2009)
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In order to protect its 3.6 million members from unnecessary premium increases, Horizon Blue Cross Blue Shield of New Jersey, (Horizon BCBSNJ) today filed a Complaint for Injunctive and Declaratory Relief against Bayonne Medical Center (BMC). The complaint states that after BMC unilaterally terminated its Network Agreement with Horizon BCBSNJ and left the Horizon BCBSNJ network on February 7, 2009, the hospital has been charging exorbitant fees and misrepresenting its fees for services, thereby, defrauding the company.Since leaving Horizon BCBSNJ’s network, BMC has dramatically increased its aggregate per day charge by over 100 percent. In 2008, the hospital’s aggregate per day charge was $13,000; in 2009, the aggregate per day charge is $29,000. At the same time, BMC announced it would not collect any portion of the out-of-network fees owed by Horizon BCBSNJ members, thereby over-billing Horizon BCBSNJ. This practice increases health care costs and premiums for everyone and hides the real cost of the services being provided by BMC. “Bayonne Medical Center is inflating and misrepresenting fees to Horizon Blue Cross Blue Shield of New Jersey.” said Jim Albano, Vice President of Healthcare Services, Horizon BCBSNJ. “This over-billing will ultimately lead to higher premiums for all.” The purpose of a health insurance network is to provide affordable access to quality care for everyone that is part of the insurance pool. Bayonne Medical Center’s practices are creating an inaccurate perception that health consumers are saving money. However, the end result is increased health care costs for Horizon BCBSNJ members. Click here to view the Complaint for Injunctive and Declaratory Relief against Bayonne Medical Center (BMC).
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