Latest News Surrounding Antitrust Litigation

Blue Cross Blue Shield AntiTrust Litigation | Monthly Archives: August 2015

Latest News surrounding Insurance Antitrust Litigation


Monthly Archives: August 2015


Health insurance is staggeringly uncompetitive in America, and is poised to get even worse for everybody


By: Max Niesen

08/26/2015

qz.com

With two major health insurance mergers pending, the US may be headed for a healthcare market with only three major private health insurers, down from the five that exist now.

 Critics argue that the pending mergers of Anthem with Cigna and Aetna with Humana will further reduce competition. But when it comes to private Medicare plans— the national social insurance called Medicare Advantage (MA) that uses private health insurers—the lack of competition is already awful. Ninety-seven percent of American counties have little or no plan competition, according to a new reportby The Commonwealth Fund, a US healthcare research foundation.
Many of the counties are sparsely populated rural areas. But even within the 100 largest counties by number of Medicare beneficiaries, 81% aren’t competitive, according to the report. Seventy-seven percent of seniors enrolled in MA live in noncompetitive counties.

The report measured competitiveness based on the Herfindahl-Hirschman Index, which classifies markets as non-concentrated, moderately concentrated, or highly concentrated based on the the number of firms within the area and their market share. The Federal Trade Commission uses the index to classify markets for antitrust purposes.

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Status Conference held in MDL 2406: In Re: Blue Cross Blue Shield Antitrust Litigation


Judge David Proctor of the Northern District of Alabama held a status conference on August 19, 2015 in MDL 2406: In Re: Blue Cross Blue Shield Antitrust Litigation. The Court heard suggestions from the parties on streamlining the case.

Joe Whatley co-lead counsel for the provider plaintiffs noted ”While we continue to push to move this important case forward efficiently and as quickly as possible, the Blues continue to try to delay the case to protect their excess reserves and profits that they reap by imposing artificial lines on competition. We look forward to a ruling from the court on our proposal to streamline the proceedings to accomplish these goals.”



Lane Regional files antitrust lawsuit against Blue Cross associations, except in Louisiana


By: Ted GriggsBaton-Rouge-Advocate-Logo-590x144

The Advocate.com

08/15/2015

Lane Regional Medical Center has filed a federal lawsuit against all of the Blue Cross plans outside Louisiana, alleging the Zachary hospital received lower payments because the health plans illegally conspired to fix prices at artificially low levels.

 Lane Regional said the lawsuit, filed Friday in Baton Rouge, is intended to force the Blue Cross plans outside the state to compete with Blue Cross and Blue Shield of Louisiana. Lane expects its lawsuit will be combined with antitrust lawsuits filed in Alabama against all of the Blue Cross plans. Those lawsuits claim the Blues acted as an illegal cartel, driving up prices for consumers while lowering payments to doctors and hospitals.

The Blues have denied those allegations. The national Blue Cross association says its members are independent, community-based and locally operated health plans. A number of courts and regulatory agencies have validated the Blues’ business model.

However, Joe Whatley, lead attorney for the Alabama multidistrict litigation, and co-counsel Lance Unglesby say the Blues’ anticompetitive behavior meant Lane was paid less for its services than it should have been.

Lane’s lawsuit was prompted in part by worries that increasing consolidation among health insurers will mean less choice for consumers and less bargaining power for health care providers. Anthem, the largest of the Blues, recently struck a $48 billion deal to purchase Cigna.

Whatley said he did not have an estimate of the Blues’ anti competitive impact on Lane but the damage to hospitals nationwide amounted to billions of dollars.

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Blue Cross Blue Shield accused of stifling competition


By: Patrick Springer

June 8, 2015

Inforum.com

FARGO – The Red River is a border the Blue Cross Blue Shield plans in North Dakota and Minnesota agree not to cross in selling health insurance to customers.

Those exclusive territorial agreements form a hallmark of Blue Cross Blue Shield plans nationwide—which collectively insure one of every three Americans—and are at the heart of a pair of federal lawsuits alleging civil antitrust.

The lawsuits, pending in U.S. District Court in Alabama, were brought separately by providers as well as by individual and small group purchasers of health insurance, and seek class-action status.

Most of the 37 Blue Cross Blue Shield plans in the United States limit their operations to a single state, including those in North Dakota and Minnesota.

 The only reason for the self-imposed geographical marketing restrictions, the providers’ lawsuit contends, is to protect the insurers from competition. The restrictions are maintained by an illegal “market allocation conspiracy,” the doctors and clinics argue

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Bigger May Be Better for Health Insurers, but Doubts Remain for Consumers


the-new-york-times-logoBy: Reed Abelson

08/02/2015

The New York Times

Bigger May Be Better for Health Insurers, but Doubts Remain for Consumers – The New York Times

Deals among the nation’s largest health insurers in recent weeks have been almost head-spinning. But whatever the details, if the combinations are finalized, the result will be an industry dominated by three colossal insurers.

Consumer advocates, policy experts and former regulators say that what may be good for the insurers may not be good for consumers, especially in the wake of a similar frenzy of deal-making among hospitals and doctors’ groups.

“The consolidation in both of these industries has been shown to have an adverse impact on consumers,” said Leemore S. Dafny, a former official at the Federal Trade Commission who is now a professor at Northwestern University’s Kellogg School of Management.

Anthem, which operates for-profit Blue Cross plans in 14 states, merging with Cigna, another large for-profit carrier, along with the planned deal for Aetna to join Humana, a smaller rival known for its private Medicare plans, would create two behemoths.

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