Author Archives: Admin

A metro-based eating disorder treatment facility claims they were cut from Blue Cross Blue Shield of Oklahoma’s in-network provider list three years ago, leaving several BCBS members wonderin…

Source: Several Blue Cross Blue Shield of Oklahoma members say they’re in jeopardy of not receiving life-saving treatment

SPRINGFIELD, Ill. (WTVO) — Lawmakers are calling for more answers from Blue Cross Blue Shield of Illinois.

This comes after the insurance company was fined $600,000 by the state, but both Republican and Democrats said that is far from enough.

The company was fined last week for violating the “Network and Transparency Act.” The state released a report on their investigation into Blue Cross Blue Shield of Illinois when they announced the fine.

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Law360 (April 3, 2023, 3:01 PM EDT) — Horizon Healthcare Services Inc. and its insurers have settled their dispute over coverage for antitrust multidistrict litigation involving Horizon and other Blue Cross Blue Shield entities, according to a New Jersey federal judge’s order, which administratively terminated the action.

U.S. District Judge Julien Xavier Neals filed an order Monday closing the action and giving the parties 60 days to either file dismissal papers or reopen the case should the settlement not be consummated.
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By: JC Reindl- Detroit Free Press

The top executive at Blue Cross Blue Shield of Michigan saw an increase last year to his eight-figure compensation package.

The Blues disclosed Wednesday that total all-cash compensation for CEO Daniel Loepp, 65, was $16.9 million in 2022. Of that amount, $13.8 million was Loepp’s bonus and $1.7 million his base salary. His total compensation was up $1.3 million from the year before, although still below Loepp’s record $19.2 million payday in 2018. He has been CEO since 2006.

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Law360 (March 24, 2023, 10:26 PM EDT) — Dozens of Blue Cross Blue Shield units are essentially withdrawing their motion to dismiss most or all of an antitrust suit accusing the insurers of curbing competition by divvying the country up between them, saying they realize the motion is likely to be denied after their arguments failed in other cases.

Bed Bath & Beyond and the other companies that are suing the various BCBS units agreed that both sides would consider the motion denied and wouldn’t engage in any further briefing on the matter, though the arguments wouldn’t be considered waived, according to the joint stipulation the parties filed Thursday in Alabama federal court.
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Law360 (March 27, 2023, 8:52 PM EDT) — Three businesses have asked the Eleventh Circuit to reverse an Alabama federal court’s approval of a $2.67 billion antitrust deal in multidistrict litigation against Blue Cross Blue Shield insurers.

In two separate briefs filed on Friday, Topographic Inc., joined by Employee Services Inc., and Home Depot Inc. argued that the Eleventh Circuit should reject the settlement approval, citing different reasons. While Topographic and Employee Services ​​said the court failed to adequately scrutinize the allocation of the settlement among plaintiffs, Home Depot warned that the current agreement would prevent national employers not participating in the settlement from making similar claims in the future.

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“It’s my partner and his life and our life that you’re messing with. Please sign that contract,” Connie Mah said.

Author: Jay Jones

ABC 24

SOUTHAVEN, Miss — As the battle between Blue Cross Blue Shield of Tennessee (BCBST) and Methodist Le Bonheur Healthcare continues, many are turning to other options. But some say their options are few.

Southaven couple Tony and Connie Mah and their family say they have been waiting in limbo as contract negotiations drag on between Blue Cross Blue Shield of Tennessee and Methodist Le Bonheur Healthcare.

Tony and Connie are Blue Cross, Blue Shield Mississippi members and received a letter from Blue Cross Blue Shield Mississippi stating that they would “no longer be a member of the Advanced Health Systems, Inc.”  

“We were just this month supposed to get on the kidney list, transplant list and now he’s not on any list,” Tony Mah’s wife, Connie, said. 

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Law360 (March 8, 2023, 6:34 PM EST) — Home Depot and others who are objecting to a $2.67 billion settlement with Blue Cross Blue Shield will only have to post a $5,000 bond in order to appeal the court’s order, a far cry from the $113 million that the judge was originally asked to approve.

U.S. District Judge R. David Proctor said Tuesday that he saw no reason to make the bond so high and that $5,000 each should be more than enough to cover the $20,000 to $25,000 that the other class members say an appeal could cost them.

“Just as the court was concerned about burdening class members’ opt-out rights … the court has concerns about imposing financial burdens on objector-appellants that might discourage, or in some instances preclude, the pursuit of an appeal,” the Alabama federal judge said.

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Law360 (February 22, 2023, 5:55 PM EST) — An Alabama federal judge refused Tuesday to toss litigation by JetBlue, Alaska Airlines, Albertsons Cos. and numerous other major national employers who offer self-funded health insurance plans accusing Anthem and its related Blue Cross entities of colluding to fix administrative service-fee prices, rejecting defense arguments that the claims are time-barred.

In a 13-page opinion, U.S. District Judge R. David Proctor held that there’s a factual question over whether the account holders’ claims prior to November 2016 have been tolled by related antitrust multidistrict litigation that was filed in 2013, which settled in 2020, and therefore the issue can’t be resolved on a motion to dismiss.

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Law360 (February 6, 2023, 5:54 PM EST) — A Georgia federal judge on Monday certified a class of medical management nurses for Anthem Cos. Inc. in their suit alleging the health insurer did not pay them overtime wages, ruling the nurses’ duties were similar enough to warrant certification.

U.S. District Judge William M. Ray II signed an order certifying a collective of nurses in Deon Baker’s Fair Labor Standards Act suit against Anthem, saying the nurses had cleared the low threshold at the conditional certification stage to prove they were similarly situated.
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