Horizon BCBS and American Specialty Health Update

On October 17, NJSHA received a written statement from Horizon BCBS that confirmed that the proposed collaboration between Horizon and American Specialty Health (ASH) will not launch on January 1, 2020. The proposal, as submitted to the NJ Department of Banking and Insurance (DOBI) did not meet all the regulatory requirements needed for approval. We are expecting a formal letter from DOBI to reinforce this.

Horizon proposed to partner with ASH to have them implement and administer the carrier’s Chiropractic & Physical Medicine Services Program for acupuncture, chiropractic, occupational therapy, physical therapy and speech therapy. While ASH is currently engaged with insurers in other states providing utilization management for the first four therapies, New Jersey would be the first state where they would be doing so for speech.

As soon as the proposal came to our attention in the late summer, NJSHA began an effort to engage with all involved parties and express our significant concerns about the proposal. Led by President Robynne Kratchman, NJSHA worked with our lobbyist and the American Speech-Language-Hearing Association (ASHA), securing a face-to-face meeting with high level administrators from both Horizon and ASH, followed by ongoing email and telephone communication. We also established an open line of communication with DOBI.

During this entire period, we were aware that there was quite a bit of contradictory information and rumors to add to the general concerns. We worked diligently to obtain clarification and share only information that has been substantiated and is accurate and verifiable, including the most recent notice that DOBI denied ASH the necessary approval for the continuation of the partnership.

NJSHA, as New Jersey’s premier professional association for speech-language pathologists and audiologists, remains committed to safeguarding our profession, our members and those we serve. Many thanks go to the significant efforts of members of NJSHA’s private practice and health care committees and our board of directors who continue to volunteer their time and energy on your behalf.

We will continue to be vigilant and monitor this situation for any updates moving forward.

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