New Jersey Health Insurer Paying $100M Settlement in Whistleblower Case

Horizon Blue Cross Blue Shield of New Jersey agreed to pay $100 million to resolve allegations in a newly unsealed lawsuit initiated by whistleblowers that accused the insurer of ripping off New Jersey taxpayers.

The settlement with the New Jersey attorney general reveals a long-running legal dispute that was unfolding in a sealed court case between the state and Horizon, even as rising expenses in the state employee health plan pushed up costs for taxpayers.

A former state official raised alarms years ago about how New Jersey’s largest health insurer, which covers about 3.7 million people, was handling public money in a lucrative contract to administer billions of dollars in payments to hospitals and doctors.

The dispute put a spotlight on how even the largest employers struggled to understand what happened to vast sums they paid for health care.

The official, Christin Deacon, filed a whistleblower lawsuit along with others seeking to recover money from Horizon on behalf of the government. The case remained under seal for years before the resolution was disclosed in court filings on Friday.

Horizon denied that it engaged in fraud as part of the settlement. A Horizon representative didn’t immediately comment.