RAHWAY HOSP. v. HORIZON BLUE CROSS


863 A.2d 1050 (2005)

374 N.J. Super. 101

RAHWAY HOSPITAL, Plaintiff-Appellant, v. HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY, Defendant-Respondent.

Superior Court of New Jersey, Appellate Division.

Decided January 3, 2005.


Attorney(s) appearing for the Case

Anthony P. LaRocco, Newark, argued the cause for appellant (Kirkpatrick & Lockhart, attorneys; Eric Tunis, of counsel; Mr. Tunis and Thomas Weisert, on the brief).

James P. Flynn, Newark, argued the cause for respondent Horizon Blue Cross Blue Shield of New Jersey (Epstein, Becker & Green, attorneys; Mr. Flynn, of counsel; Shiela A. Woolson, on the brief).

Denise M. Illes, Deputy Attorney General, argued the cause for respondent New Jersey Department of Banking and Insurance (Peter C. Harvey, Attorney General, attorney; Patrick DeAlmeida, Assistant Attorney General, of counsel; Ms. Illes, on the brief).

James A. Robertson argued the cause for amicus curiae New Jersey Hospital Association (Kalison, McBride, Jackson & Murphy, attorneys; Andrew F. McBride, III, of counsel; Mr. McBride, Mr. Robertson and John J. Deno, on the brief).

Before Judges LEFELT, ALLEY and FALCONE.


The opinion of the court was delivered by

LEFELT, J.A.D.

This appeal focuses on the four-month period following termination of Rahway Hospital's in-network health-care services agreement with Horizon Blue Cross Blue Shield of New Jersey, a non-profit health insurer. The determinative issue is whether the Commissioner of the Department of Banking and Insurance correctly construed N.J.S.A. 17:48E-10(a)(2), of the Health Service Corporations Act (HSCA...

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