Horizon Blue Cross Blue Shield of New Jersey is making leadership changes as it girds for several lawsuits involving its Omnia health plans.
Seventeen N.J. hospitals allege in a brief filed in November that the state Department of Banking and Insurance didn't follow proper procedures for approving Horizon's Omnia Health Alliance and Health Plan. The department “failed to comply with its own regulations concerning network adequacy and abdicated its responsibility to ensure that the Omnia Plan was not contrary to the public interest,” according to court documents.
Bill Castner was named senior VP of corporate and regulatory affairs at the Newark, N.J.-based insurer.
Dominick DiRocco is Horizon's director of government affairs. He previously served as Gov. Chris Christie's deputy chief of staff.
Ulises Diaz, the former VP of government affairs for Verizon New Jersey, will serve as director of enterprise government affairs.
Michele Jaker, a former chief of staff to state Sen. Joseph Vitale, joins the government affairs team under Diaz. She and DiRocco join Government Affairs Director John Rogers, who is the former chief counsel to the state Assembly Republican Office.
Additionally, Sarah Jones was named government affairs manager. Jones previously served as the director of government affairs for Cablevision.
Scarlett Rajski will now serve as Horizon's government affairs specialist. She is the former project manager for the government affairs department of law firm Gibbons.
The hospitals suing Horizon want the state's insurance department to put the plan on hold pending review of the approval process. If the department refuses, the hospitals will challenge that in court.
The plan divides hospitals into two tiers, with the less expensive tier for plan members. The 17 hospitals were placed into the more expensive tier, which they argue will prevent plan members from accessing certain services. The hospitals also argue the plan could destabilize the New Jersey hospital system as a whole by endangering the financial health of hospitals in the lower tier, which may lose large numbers of patients.
Horizon then sued Teaneck, N.J.-based Holy Name Medical Center and Valley Hospital in Ridgewood, N.J., for public comments that Horizon alleges imply the coverage by its Omnia policies is deficient.