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Law360 (July 28, 2021, 7:56 PM EDT) — Health care providers accusing Blue Cross Blue Shield organizations of thwarting competition by carving up the national market into service areas and refusing to compete against each other are asking an Alabama federal court to revisit the insurers’ argument that it is a single entity.

In a motion for summary judgment filed Tuesday, health care providers argued BCBS is multiple entities working to manipulate the market. If granted, the judgment would wipe out one of BCBS’ defenses and add leverage to their providers’ arguments accusing it and the array of affiliated insurers of conspiring to divide the market among themselves and not compete with one another through a series of trademark licensing agreements and other arrangements.

“Potential competitors never act as a single entity when they agree to insulate themselves from competition by allocating territory or restricting output,” the providers said. “The Blues, who resisted being called a single entity until this case was filed, are no exception.”

The provider plaintiffs, who are still pursuing their track of the multidistrict litigation after Blue Cross Blue Shield subscribers settled their own claims last year for a $2.67 billion class payout, are trying to secure at least $15 billion after trebling for antitrust damages in the Alabama market alone.

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By: Colette Ngo

KSBY 6

In California, Dignity Health and Anthem Blue Cross have terminated their network agreement. This removes Dignity hospitals and medical clinics across California from Anthem’s network.

For the past six months, Dignity Health and Anthem Blue Cross have been in contract negotiations.

Despite their efforts, most of Dignity Health’s California agreements with Anthem were terminated on July 16,

Anthem Blue Cross members received a letter in the mail notifying them that Dignity Health doctors and hospitals will no longer be in their plan’s network.

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By: Nick Moran

Beckers Hospital Review

After Dignity Health issued a contract termination notice in January, the health system and Anthem have ended their relationship as of July 16.

Anthem claimed in a statement the relationship primarily fizzled out because the insurer refused to agree to rate increases that would continue to make San Francisco-based Dignity more expensive than other systems. The insurer said Dignity is nearly 30 percent more expensive than other California health systems. 

An Anthem spokesperson told Becker’s that it is still negotiating with Dignity, but has made members aware of alternatives in the interim.

“Anthem Blue Cross (Anthem) is currently in active negotiations with Dignity Health (Dignity) and working to reach a fair agreement that would keep Dignity in our provider network,” Anthem said in a statement to Becker’s. “Maintaining stability in our network of local doctors and hospitals is extremely important to us. As we negotiate with providers, we try to strike a balance between protecting affordability and providing a broad network of providers to create choices, which can take time.”

A Dignity spokesperson also confirmed negotiations are ongoing, but cited inflation costs as a point of contention. They pointed to the company’s website dedicated to the negotiation process for more information.

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El Camino Health severs ties with country’s second largest health insurer

by Kevin Forestieri / Mountain View Voice

El Camino Health terminated its contract with Anthem Blue Cross last month over price disputes, suddenly putting the hospital out of network for those covered by the country’s second-largest health insurer.

But it’s not the first time and it’s unlikely to be the last, as many Bay Area hospitals are finding it tough to live with Anthem’s price-cutting tactics.

Rising health care costs are at the heart of these clashes, which are happening with surprising regularity. El Camino and Stanford Health Care have both temporarily dropped Anthem at least three times over the last decade, along with MarinHealth last year and Sutter Health in 2019.

The story is almost always the same: The hospitals accuse Anthem of penny pinching and paying less for services than other insurers, while Anthem describes health care costs in Northern California as unreasonably high and partly to blame for the country’s high cost for health care.

These disputes rarely happen between local hospitals and other health insurers.

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Law360 (July 9, 2021, 9:59 AM EDT) — President Joe Biden on Friday issued an expansive executive order aimed at boosting competition across the U.S. economy and lowering prices for consumers and increasing pay for workers.

With an eye toward halting consolidation that Biden said has led to higher prices and lost jobs, the president ordered merger enforcers to challenge deals that not only are likely to raise prices for consumers but also may harm labor, agricultural and health care markets and hinder new business formation. 

The order requires 72 initiatives by more than a dozen federal agencies and also specifically targets barriers to competition that Biden said has led to higher prices for food, prescription drugs, hearing aids, internet service, airfares, consumer products, rent, financial transactions and telecommunications services, The order also aims to boost wages in a variety of industries and make it easier for small business to compete.

“Once implemented, these initiatives will result in concrete improvements to people’s lives” by addressing a lack of competition that costs the median American household $5,000 per year, the Oval Office said in its statement announcing the order.

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The U.S. economy suffers from a lack of competition. President Biden wants to change that.

By: David Leonhardt

July 9, 2021

New York Times

The U.S. economy has been less dynamic in the 21st century, by many measures, than it was in the late 20th century.Get The Morning by email  Make sense of the day’s news and ideas with this daily newsletter. Sign up.

Fewer new businesses are starting. Existing businesses have slowed the pace at which they hire new workers (as the chart here shows). Workers are less likely to switch jobs or move to a new city. Companies are investing in new buildings and equipment at a lower rate. And small businesses make up a shrinking share of the economy.

Together, these trends suggest that the economy suffers from a lack of fair competition, many economists believe. Large corporations are often able to increase profits not by providing better products than their rivals but instead by being so big that they exercise power over workers and consumers. The government also plays a role, through policies that protect existing companies at the expense of start-ups and new entrants into an industry.

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The Provider Plaintiffs have filed motions for Partial Summary Judgment Regarding the Standard of Review in Light of Amex (Doc. 2743) and the Standard of Review for Their Group Boycott Claims (Doc. 2741) in MDL No. 2406 in Re: Blue Cross Blue Shield Litigation.

Provider Plaintiffs Motion for Partial Summary Judgment Regarding the Standard of Review in Light of Amex.

Provider Plaintiff Motion for Partial Summary Judgment Regarding the Standard of Review for Their Group Boycott Claims

By: Shannon Rousseau, News on 6

TULSA, Oklahoma – 

Blue Cross and Blue Shield of Oklahoma confirmed it will be ending its contract with Saint Francis Health System. 

The contract ended six days ago on April 1, but Blue Cross and Blue Shield of Oklahoma (BCBSOK) is currently in a 90-day transition period. This means BCBSOK members will still have in-network access to Saint Francis locations, clinics, and physicians until July 29, 2021.

This is expected to impact about 59,000 subscriber households. Those currently receiving care for a disability, acute condition, life-threatening illness, or are in their second trimester of pregnancy could still be covered by Continuity of Care beyond July 29. To check eligibility in Continuity of Care benefits, BCBSOK members should call the customer service number on the back of their ID card.

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By CHRIS POLANSKY • MAY 7, 2021

After health insurer Blue Cross Blue Shield of Oklahoma announced Wednesday that Saint Francis Health System would be leaving its network because of failed contract negotiations, Saint Francis issued a news release Friday saying they wish to resume talks.

In a statement, Jake Henry Jr., president and CEO of SFHS, said the two entities had been negotiating since January and reached an agreement on the afternoon of April 30th, the final day of the previous contract.

“While waiting for the contract, BlueCross unexpectedly sent new terms at 10:02 p.m. on Friday night with provisions that had not been agreed on earlier. The added terms materially changed the agreement. It wasn’t a contract that I could sign–it wasn’t what we agreed to just a few hours earlier,” Henry said.

“I am still ready to sign the contract I agreed to that afternoon. Saint Francis Health System is ready to put the issue to rest and move forward,” Henry said. “We’ve all been through a lot this past year. Our patients, healthcare workers and the community have had enough to worry about related to their health and wellness. We’re just a few signatures away from being able to put this behind us…my pen is ready.”

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By: Amy Yurkanin

Al.com

People covered by Blue Cross plans between February 2008 and October 2020 could be eligible for part of a historic $2.7 billion settlement approved in Alabama last year as part of a long-running antitrust case.

Attorneys could receive about $700 million from the settlement, which leaves about $1.9 billion for people covered by Blue Cross Blue Shield plans during that time. Subscribers have until November 5, 2021 to make a claim online or by mail. Some of those eligible to file a claim may have received postcards notifying them of filing deadlines.

Claims can be filed online at the Blue Cross settlement website, which also offers additional information about who qualifies.

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