Law360(October 15, 2024, 6:54 PM EDT)

The Blue Cross Blue Shield network will shell out $2.8 billion and invest “hundreds of millions” more overhauling its claims systems to soften barriers between members, in a massive antitrust settlement disclosed Monday in Alabama federal court under which healthcare providers’ counsel stands to reap up to $700 million.

Billed as “the largest-ever payment in a healthcare antitrust case, and one of the largest in any antitrust case,” the deal with a class of providers comes on top of a $2.67 billion settlement that the Blue Cross Blue Shield Association and its members previously cut with network subscribers, resolving allegations that the defendants illegally carved up the country and blocked competition between BCBS members.
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By Mike Scarcella / Reuters

Insurer Blue Cross Blue Shield has agreed to pay $2.8 billion to resolve antitrust class action claims by hospital systems, physicians and other health providers alleging they were underpaid for reimbursements, the plaintiffs said in an Alabama federal court filing today.

The settlement is the largest ever for a healthcare antitrust case, they added.

Blue Cross Blue Shield denied the allegations in a statement, but said it agreed to the settlement and make operational changes to “put years of litigation behind us.”

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BIRMINGHAM, AL – Today a monumental settlement was announced by Whatley Kallas, LLP, Co-Lead Counsel, in a long-running antitrust lawsuit filed on behalf of healthcare providers across the nation. The settlement with all the Blue Cross and Blue Shield entities in the country, as well as the Blue Cross and Blue Shield Association, provides billions of dollars for healthcare providers and is the largest antitrust settlement in the history of the United States healthcare industry. The settlement includes a $2.8 billion cash payment into a settlement fund, as well as investments by the Blues of hundreds of millions of dollars in system improvements for the benefit of providers. Provider Plaintiffs have asked the court to preliminarily approve the settlement, which would resolve their claims that the Blues violated the antitrust laws by, among other things, agreeing to allocate markets through the use of exclusive service areas and to fix the prices paid to providers through the BlueCard Program.

Law360(August 16, 2024, 6:37 PM EDT)

A Georgia Blue Cross Blue Shield unit is fighting a California hospital’s push to have a lawsuit seeking $905,000 in reimbursements sent back to a Georgia state court, arguing the hospital’s state law claims are preempted by the federal Employee Retirement Income Security Act.

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By Matthew Perlman ·  Listen to articleLaw360 (June 24, 2024, 9:54 AM EDT)  — The U.S. Supreme Court refused on Monday to review Home Depot‘s challenge of a $2.67 billion settlement in antitrust litigation targeting Blue Cross Blue Shield, along with a separate challenge of the attorney fees awarded for the deal.

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Since an agreement has not been reached, Anthem now considers 11 Colorado hospitals and dozens of clinics and practices as out-of-network.

By: Claire Lavezzorio

Posted at 9:34 PM, May 01, 2024

LAKEWOOD, Colo. — After failed contract negotiations, more than 40,000 Colorado patients with Anthem Blue Cross Blue Shield insurance no longer have in-network access to nearly all of CommonSpirit’s hospitals, clinics and physicians.

The contract terminated at 11:59 p.m. on April 30, and Anthem removed CommonSpirit from its network beginning May 1.

A spokeswoman for Anthem said the insurance company has offered CommonSpirit a multi-year agreement that includes “reasonable reimbursement rates” but said, “CommonSpirit wants to unacceptably increase costs for Colorado consumers and employers.”

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Law360(April 30, 2024, 7:36 PM EDT) — A member of the class that settled multidistrict litigation with Blue Cross Blue Shield for $2.67 billion over anti-competitive practices has asked the U.S. Supreme Court to take up his challenge to the $626 million attorney fees award in the settlement, arguing the Eleventh Circuit’s approval of the award runs counter to high court precedent.

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U.S. District Judge Linda V. Parker of the Eastern District of Michigan entered an Order on motions to dismiss on March 30, 2024.

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By Danielle Ferguson · 

Law360 (April 1, 2024, 6:23 PM EDT) — A Michigan federal judge has trimmed some of Ford Motor Co.’s time-barred claims alleging Blue Cross Blue Shield engaged in an anti-competitive scheme to drive up prices, but said the auto giant established it had standing to pursue allegations it was injured by market-restricting agreements among insurance licensees.

U.S. District Judge Linda V. Parker said Thursday that Ford’s alleged antitrust injuries from buying unreasonably expensive administrative services only, or ASO, products from BCBS as far back as 2013 are outside the statutory four-year window for seeking such claims.

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