New Jersey's state health plan paid providers millions in overpayments

New Jersey's state employee health plan, managed by Horizon Blue Cross Blue Shield of New Jersey, paid millions over what providers charged, Bloomberg reported Dec. 12. 

Bloomberg obtained open records showing the state sometimes paid hundreds of thousands of dollars over what hospitals charged for a single hospital stay. 

In one case, a hospital billed $674,856 for a patient's hospital stay, but the state's health plan paid over $2 million to the provider. 

The state's contract with Horizon BCBS bars overpayments, Bloomberg reported. 

A spokesperson for the state told the outlet the state is investigating these overpayments and "aggressively enforcing" its contract with the payer. 

A spokesperson for Horizon BCBS said it disagrees with New Jersey's claims it is not complying with the contract. Horizon BCBS's approach has led to the lowest cumulative cost of care for the state, the spokesperson told Bloomberg. 

Read the full investigation here.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months