AG Platkin: Horizon Agrees to Settle False Claims Act Case for $100 Million 

Health Insurer Grossly Overcharged the State, Knowingly Violating Key Cost-Saving Contract Term

State’s Complaint in Intervention | Settlement Agreement

Attorney General Matthew J. Platkin announced today that Horizon Healthcare Services, Inc., which does business as Horizon Blue Cross Blue Shield of New Jersey, agreed to pay New Jersey $100 million to settle allegations that it fraudulently induced the State to enter into a 2020 contract to administer the State’s employee benefit programs, and then systematically overcharged the State for healthcare claims throughout the life of that contract. Today’s agreement is the State’s largest-ever non-Medicaid False Claims Act settlement.

The agreement settles allegations that Horizon violated New Jersey’s False Claims Act (NJFCA),…