NEW YORK—

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.

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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.

On September 30, 2014 counsel for Provider Plaintiffs filed an Consolidated Amended Complaint against the various Blue Cross and Blue Shield Plans as well the Blue Cross and Blue Shield Association.

To view a copy of the Complaint please click here: Second Amended Provider Complaint

By Kristen Consillio

Honolulu Star

The Hawaii Medical Service Association boosted compensation for its chief executive Michael Gold by 19 percent to $1.3 million last year as the state’s top insurer prepared to roll out Obamacare.

Gold was one of four isle health insurance executives who received substantial raises as President Barack Obama’s Affordable Care Act overhauled the insurance industry with new benefit requirements and expanded coverage to an estimated 30 million Americans

By: Chad Terhune

LA Times

August 19, 2014

Health insurance giant Anthem Blue Cross faces another lawsuit over switching consumers to narrow-network health plans — with limited selections of doctors — during the rollout of Obamacare.

These types of complaints have already sparked an ongoing investigation by California regulators and other lawsuits seeking class-action status against Anthem and rival Blue Shield of California.

A group of 33 Anthem customers filed suit Tuesday in Los Angeles County Superior Court against the health insurer, which is a unit of WellPoint Inc. Anthem is California’s largest for-profit health insurer and had the biggest enrollment this year in individual policies in the Covered California exchange.

In the latest suit, Anthem members accuse the company of misrepresenting the size of its physician networks and the insurance benefits provided in new plans offered under the Affordable Care Act.

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By Mike Oliver | moliver@al.com AL.com

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The top 10 executives at Blue Cross and Blue Shield of Alabama made more than $1 million each in 2013 and collectively have doubled their pay since 2011.

These raises come amid sweeping health insurance reforms dubbed Obamacare, that have left many frustrated by premium increases.

The million-dollar club is headed by president and CEO Terry D. Kellog whose total annual compensation was $4.84 million.

That includes a salary of $999,959, bonuses totaling $3,580,651 and other compensation of $257,227.

His total compensation in 2013 is a 95.5 percent raise since 2011 when his total compensation was $2.47 million.

On average, the top 10 executives, as listed on a report filed with the Alabama Department of Insurance, increased their total compensation 103 percent from 2011 to 2013.

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July 31, 2014

A fight over money between Regional Medical Center and Blue Cross and Blue Shield of Alabama could leave the insurer’s customers without coverage at the Anniston-based hospital network in September.

RMC officials say Blue Cross should pay more for the hospital’s services to match what the insurer pays other area hospitals — allowing it to stay competitive. Meanwhile, Blue Cross says it won’t increase its reimbursements to RMC, arguing that to do so would raise customers’ premiums too much.

In a Thursday press release, Blue Cross stated that RMC is terminating its contract with the company, effective Sept. 12. As a result, most services offered at RMC will not be covered by Blue Cross insurance after that date, the press release states. Blue Cross will still be required to cover any emergency treatments performed in RMC’s emergency rooms.

After Sept. 12, the nonprofit RMC will become the only hospital in Alabama not included in Blue Cross’ statewide network, the press release states. Blue Cross has been informing its customers and the medical community about the situation in recent days and pointing them to other hospitals to use instead of RMC.

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By: Dan Munro

The headline may sound fictional — but it really isn’t. It’s actually a compilation of two articles that appeared just one week apart earlier this month.

The first was a press release from the Blue Cross Blue Shield Association (BCBSA) — the parent organization of the 37 independent Blue Cross Blue Shield companies around the country.

Initial reports from the survey [of BCBS companies] show savings of $500 million in 2012. BCBSA Press Release — July 9, 2014

The second article appeared earlier this week based on state filings by BlueCross BlueShield of Tennessee (BCBST).

BlueCross BlueShield of Tennessee — the state’s dominant health insurance provider — is asking to raise rates by an average of 19 percent for its exchange plans in 2015, according to documents filed with the state of Tennessee. The Tennessean — July 16, 2014

In effect, the move to “value-based” care has resulted in $500 million in “savings” across the 37 independent BCBSA companies, but at least one of the 37 — BlueCross BlueShield of Tennessee — still needs a rate increase of 19% for 2015 to stop hemorrhaging millions per month.

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By Mike Oliver | moliver@al.com 
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on July 07, 2014 at 10:06 AM, updated July 07, 2014 at 10:14 AM

 BIRMINGHAM, Alabama — A federal  judge’s ruling June 18 that an antitrust  lawsuit filed in federal court here can continue has inspired several legal write-ups highlighting the significance of the case.

“The results of this challenge to the structure of the Blues could have an enormous impact on competition in the health care industry,” states a legal analysis by  Robert Craig for Taft Stettinius & Hollister.

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