Horizon Blue Cross Blue Shield will be required to pull back the curtain on the methods it used to develop its tiered-provider OMNIA plan following a Bergen County Superior Court judge’s ruling earlier this month that the insurer does not have the right to keep such knowledge from public view.

In his decision, Judge Robert Contillo wrote, “There is broad, legitimate, immediate public interest in how health care is delivered in this State, how patients are insured, and how they are incentivized to be evaluated, tested and treated by particular providers.”

OMNIA uses incentives to drive patients toward preferred providers. In 2015, health systems relegated to the plan’s lower provider tier sued to force Horizon to disclose the methods it used to determine which providers would be included in its Tier 1 network.

Get the full story here, from NJ Spotlight‘s Lilo H. Stainton.