Facebook Twitter E-mail
magnify
formats

In suit, Blue Shield cites extravagant spending by fired executive

Published on April 27, 2015 by in News

By: Chad Terhunela times logo

LA TIMES

April 24, 2015

In suit, Blue Shield cites extravagant spending by fired executive – LA Times

ue Shield of California fired a top executive last month after he spent more than $100,000 on his corporate credit card, the company says, including on trips with girlfriend and “Sharknado” actress Tara Reid.

The details surfaced in a countersuit the health insurance giant filed Tuesday alleging fraud by Aaron Kaufman, the company’s former chief technology officer.

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

Wagons Circle On Blue Cross And Blue Shield Tax Exemptions

Published on April 13, 2015 by in News

Forbes-Logo-

 

By: Bruce Japsen

Forbes

04/06/2015

Tax exemptions of profit-making health care businesses, long controversial in an industry that is taking hold of a greater share of the U.S. economy, are coming under fire once again.

This time, it’s nonprofit health insurance companies like Blue Shield of California, which recently lost its state income tax exemption after a government audit. Though Blue Shield of California is protesting the decision of the California Franchise Tax Board, the Los Angeles Times’ Chad Terhune, who is doggedly following the story, reported that the insurer paid $63 million in back taxes to the state for 2013 and 2014.

At issue in these tax disputes generally centers on the business behavior of a health care company that has had an exemption for decades, but challenges emerge as critics see actions differing little from health businesses that do pay taxes. Tax-exempt hospitals, too, have lost income or property tax exemptions when their missions to treat the poor and uninsured don’t mesh with actions that have included overzealous bill collecting, high prices and lack of care to the indigent.

To Read More

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

Could Blue Cross Blue Shield of Alabama ever lose its tax exempt status?

Published on April 1, 2015 by in News

By: Amy Yurkanin

Al.com

03/20/2015

al_com_logoState tax regulators revoked the tax exempt status of Blue Shield of California several months ago, a rare step that could have implications in Alabama and other states because of a class action lawsuit that has been consolidated in a Birmingham court.

Blue Cross Blue Shield companies operate independently in different states, but are represented nationally by the Blue Cross Blue Shield Association. A lawsuit consolidated in the Northern District of Alabama alleges the companies conspire to decrease competition and drive up market share. The Blues then use that market advantage to amass large reserves and increase the size of executive salaries, according to the lawsuit. The original lawsuit was filed in 2012 by a Birmingham chiropractor, but has since grown to include several medical providers and Blue Cross Blue Shield affiliates all over the country.

One of the defendants is Blue Shield of California. The California Franchise Tax Board stripped that insurance company of its tax exempt status last year, according to the Los Angeles Times. California Insurance Commissioner Dave Jones told the paper Blue Shield acts like a for-profit company, echoing the argument submitted in the lawsuit. The tax board has not yet released the reasons for stripping the insurance company of its status, but the decision did follow an extensive audit of the company, according to the LA Times. Blue Shield of California has about $4.2 billion in reserves, and Blue Cross and Blue Shield of Alabama has about $2.6 billion in reserves, according to the Alabama Department of Insurance.

“There is an important relationship between what is happening in California and what is happening in our case,” said Joe Whatley, an attorney for the parties suing Blue Cross Blue Shield-affiliated insurers. “While they claim to be non-profit, they charge their insured more than they should and they pay their providers less than they should. They build up these huge reserves, more than are needed under any circumstances.”

To Read More

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

Blue Shield seeks to avoid disclosing its price for Care1st

Published on March 23, 2015 by in News

la times logoBy: Chad Terhune

LA TIMES

03/20/2015

Nonprofit insurer Blue Shield of California, already under scrutiny for its huge cash reserves and lack of disclosure, is refusing to say how much it’s spending to acquire a Monterey Park insurance company and is seeking confidentiality from state regulators..

The California Department of Managed Health Care said Friday it was still weighing Blue Shield’s request for confidentiality after receiving a public-records request from The Times and being asked to hold a public hearing on the deal by a former company official.

The documents in question pertain to Blue Shield’s proposed acquisition of Care1st, a health plan with more than 500,000 members.

The companies didn’t disclose the terms when the transaction was announced in December. They asked regulators to keep certain details out of public view in filings submitted to the state for review Jan. 30.

To Read More

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

With billions in the bank, Blue Shield of California loses its state tax-exempt status

Published on March 18, 2015 by in News

By: Chad Terhune

la times logoLA TIMES

March 18, 2015

Authorities have revoked the tax-exempt status of nonprofit Blue Shield of California, potentially putting it on the hook for tens of millions of dollars in state taxes each year.

The move by the California Franchise Tax Board comes as the state’s third-largest health insurer faces fresh criticism over its rate hikes, executive pay and $4.2 billion in financial reserves.

The state quietly stripped the San Francisco insurer of its exemption from California income taxes in August. The company held that since its founding in 1939.

A spokeswoman for the tax agency declined to comment on the reasons for revocation. The highly unusual action comes after a lengthy state audit that looked at the justification for Blue Shield’s taxpayer subsidy. The insurer has paid federal taxes for years.

Click to Read More

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

MDL 2406 Blue Cross Blue Shield Antitrust Litigation Status Conference

Published on March 17, 2015 by in News

Judge David Proctor of the Northern District of Alabama presided over a scheduled Status Conference Hearing in MDL 2406 on Tuesday, March 17, 2015 at 10:00 AM in Birmingham, Alabama.

The putative class action addresses antitrust and unfair business practice claims made by both healthcare Providers and health plan Subscribers against Blue Cross and Blue Shield plans and associated entities across the country.

Today’s hearing focused on jurisdictional issues as well as specific preliminary issues associated with individual Blue Cross and Blue Shield plans.

The Provider plaintiffs are represented by co-lead counsel Edith Kallas and Joe Whatley and Subscriber plaintiffs are represented by co-lead counsel David Boies and Michael Hausfield. Co-lead Counsel Joe Whatley stated ” We feel good with the way the arguments went on in persona jurisdiction and we look forward to the Court’s ruling.”

For additional information follow  www.BluesAntitrustlitigation.com.

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

Bronson, Blue Cross of Michigan still in talks for new contract

Published on February 11, 2015 by in News

By: Andy Fitzpatrick

Battle Creek Enquirerbattle creek

02/09/15

As the Sunday deadline nears for Bronson Healthcare and Blue Cross Blue Shield of Michigan to work out a contract, it’s not clear if any progress has been made.

In January, the Enquirer reported that Kalamazoo-based Bronson, which operates Bronson Battle Creek hospital among several other facilities in southwestern Michigan, was negotiating a new contract with BCBSM. That contract would continue in-network coverage for inpatient and outpatient services at Bronson hospitals.

BCBSM sent a letter to customers in January saying that coverage of Bronson services could be considered out-of-network by Feb. 15. Only commercial BCBSM and Blue Care Network insurance plans are affected; Medicare supplement plans are not.

To Read the Rest of the Article

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

MDL 2406 Blue Cross Blue Shield Antitrust Litigation Status Conference

Published on January 30, 2015 by in News

Judge David Proctor of the Northern District of Alabama presided over a scheduled Status Conference Hearing in MDL 2406 on Wednesday, January 21, 2015 at 10:00 AM in Birmingham, Alabama.

The Hearing addressed a number of issues to include the status of various Motions to Dismiss, Amended Complaints, on-going discovery issues, jurisdictional questions and administrative matters.  Lead counsel for both Plaintiff tracks and Defense addressed scheduled issues and responded to issues presented by the Court.  The putative class action brought by both Provider and Subscriber plaintiffs against a number of affiliated healthcare entities has been centralized before Judge David Proctor by the Multidistrict Litigation Panel.

The case addresses health insurance issues and contracts involving both providers and plan subscribers.  Magistrate Judge Putnam and Special Master Ed Gentle also participated.   Initial Motions to Dismiss have been denied and the case will continue before Judge Proctor.

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

Hippocratic Oath Updated To Include Vow Of Loyalty To Blue Cross Blue Shield

Published on December 15, 2014 by in News

NEW YORK—onion_bg-766346

The Onion

In an effort to modernize the ancient ethics pledge, officials from the American Medical Association announced Tuesday an update to the Hippocratic Oath that includes a vow of loyalty to national health insurance giant Blue Cross Blue Shield. “This newly revised pledge requires doctors to uphold their allegiance to Blue Cross Blue Shield, to avoid pricey tests and referrals whenever possible, and to do no harm to any in-network patient so far as it remains sufficiently cost-effective,” said AMA spokesperson Amanda Cummings, noting a further addition to the professional oath that obligates doctors to enforce all co-pays and coinsurance payments. “The updated text also requires physicians to have a comprehensive working knowledge of their specific financial agreement with Blue Cross Blue Shield. And above all, a doctor must, at all times, avoid inflicting any injury or wrong upon the company’s bottom line.” Officials added that the new pledge would no longer require doctors to swear by “Apollo the physician, and Aesculapius the surgeon, and likewise Hygeia and Panacea,” but rather by Blue Cross Blue Shield CEO Scott Serota.

To Read More

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
formats

MDL 2406 Blue Cross Blue Shield Antitrust Litigation Status Conference

Published on November 8, 2014 by in News

Judge David Proctor of the Northern District of Alabama presided over a scheduled Status Conference Hearing in MDL 2406 on Friday, November 07 at 10:00 AM in Birmingham, Alabama.

The Hearing addressed a number of issues to include the status of various Motions to Dismiss, Amended Complaints, on-going discovery issues, jurisdictional questions and administrative matters.  Lead counsel for both Plaintiff tracks and Defense addressed scheduled issues and responded to issues presented by the Court.  The putative class action brought by both Provider and Subscriber plaintiffs against a number of affiliated healthcare entities has been centralized before Judge David Proctor by the Multidistrict Litigation Panel.

The case addresses health insurance issues and contracts involving both providers and plan subscribers.  Magistrate Judge Putnam and Special Master Ed Gentle also participated.   Initial Motions to Dismiss have been denied and the case will continue before Judge Proctor.

 
 Share on Facebook Share on Twitter Share on Reddit Share on LinkedIn
© Whatley Kallas BluesAntiTrustLitigation