The state alleged the insurer was charging the state more than what health care providers billed for services. Horizon said the facts were distorted.
NEWARK, New Jersey — New Jersey Attorney General Matt Platkin on Friday announced a $100 million settlement with Horizon Blue Cross Blue Shield of New Jersey claiming that the insurer fraudulently overcharged the state for health care on its public employee health plans.
The announcement from Platkin stems from Horizon’s contract with the state to administer its multibillion-dollar public worker health insurance programs, which provides health insurance to around 750,000 New Jerseyans. The state alleges that Horizon violated a portion of its contract aimed at saving taxpayers money known as the “lessor of” provision — specifically, that Horizon was required to charge the lesser amount between what health care providers billed for services and the rate Horizon had previously negotiated with those providers in advance.
Instead, the state claims, Horizon charged the higher amount.
“Today’s settlement makes a very clear statement: We send a message to Horizon and to the entire insurance industry that they cannot take advantage of the state,” Platkin said during a press conference. “They cannot make us all illegally pay more for health care. No one is entitled to our business and they are not entitled to New Jersey taxpayer money either.”
Horizon, as part of the settlement, denies any wrongdoing.
Horizon’s book of business with...
From misinformation surrounding the tragic Tejas fighter jet crash at the Dubai Airshow, which claimed the life of the pilot, to a manipulated video falsely showing Indian Army Chief General Upend...