Horizon Agrees to Settle False Claims Act Case for $100 Million
Through rigorous analysis and deep industry insight, AVYM principals Mark Flores and Vince Flores assisted state officials in identifying systemic misconduct by Horizon BCBS NJ. This collaboration helped secure a historic settlement and protect public plan assets from misuse.
Mark Flores, a nationally recognized health benefits consultant, expressed his appreciation to the Office of the Attorney General: “We are grateful to Attorney General Platkin and the dedicated attorneys in the Government and Healthcare Fraud Unit for recognizing the importance of these issues, thoroughly investigating our allegations, and pursuing this case to protect State Health Plan members and New Jersey taxpayers.”
Vince Flores, also a leading health benefits consultant, added: “We hope this settlement prompts Horizon, and other health insurers, to take a hard look at how they administer self-funded plans and ensure they are meeting their fiduciary and administrative obligations.”
