4TRENTON, NJ – New Jersey Attorney General Matthew J. Platkin announced Friday that Horizon Blue Cross Blue Shield of New Jersey agreed to pay $100 million to settle allegations it defrauded the state by overcharging healthcare costs under a 2020 benefits contract.

The case marks the state’s largest-ever non-Medicaid False Claims Act settlement.

The State alleged that Horizon knowingly violated the terms of its 2020 contract to administer health benefits for public employees and school workers, submitting inflated claims and false records to the State Health Benefits and School Employees’ Health Benefits programs.

Key Points

Horizon will pay $100 million to settle state fraud claims tied to 2020 health contract.

The company was accused of overbilling and violating “lesser of” pricing

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