Horizon and the state have a contract that partially reimburses the state if the payer doesn’t meet specific medical cost limits. Horizon negotiates prices with providers, while the state pays medical expenses out of pocket.
In 2020, the company paid a $24 million fine for increasing costs higher than the agreed rate.
“They failed to deliver on their promise” in 2020, the state Policemen’s Benevolent Association president, Patrick Colligan, wrote publicly. Because premiums have increased, “there is little doubt that they have continued to fail to deliver.”
“According to the state and its consultants, Horizon has met those cost benchmarks,” a Horizon spokesperson told Bloomberg in September.
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