Blue Cross Network Antitrust Action

[somarco]

Dozens of providers have filed new lawsuits against Blues insurers, arguing that the plans colluded to block competition and reimburse them at lower rates.

The payers reached a tentative $2.8 billion settlement agreement in Alabama court in October, but the new lawsuits opt out of it and instead press for a jury trial. The Blue Cross Blue Shield Association and 33 of its affiliates are named in the new suits.

The ongoing legal fight stretches back a decade, with providers across the country arguing that the Blues network divvied up geographic regions to avoid competing against one another directly. Doing so enabled them to increase insurance costs and lower reimbursements.

Alongside the settlement agreement reached in October, Blues insurers agreed to make changes to the BlueCard program, a provider-facing platform they can use to track claims, file prior authorization requests and submit questions to the insurer.

In new lawsuits, dozens of health systems opt out of $2.8B Blues network antitrust settlement

Dozens of providers have filed new lawsuits against Blues insurers, arguing that the plans colluded to block competition and reimburse them at lower rates. | Dozens of providers have filed new lawsuits against Blues insurers, arguing that the plans colluded to block competition and reimburse...

www.fiercehealthcare.com

 

[LeeV]

I just have to laugh at all of this. I do understand the concerns and financial strains the providers have. But 2 things come to mind. The first is that no one put a gun to their heads when they signed the agreements. The other is when I consider how and why the original plans were started. The hospital side started as a way for the hospital to insure a flow of money to them. When the physicians saw the success, they created Blue Shield, again, as a way to insure they get paid.

 

[somarco]

The first is that no one put a gun to their heads when they signed the agreements. The other is when I consider how and why the original plans were started. The hospital side started as a way for the hospital to insure a flow of money to them.

Greed . . . is good - Gordon Gecko

 

[annon123]

I just have to laugh at all of this. I do understand the concerns and financial strains the providers have. But 2 things come to mind. The first is that no one put a gun to their heads when they signed the agreements. The other is when I consider how and why the original plans were started. The hospital side started as a way for the hospital to insure a flow of money to them. When the physicians saw the success, they created Blue Shield, again, as a way to insure they get paid.

Locally the state university medical system dropped BCBS for close to two years as they argued about reimbursement. Ironically the state employees (of which they all were in the medical center) had their insurance administered by BCBS (but the medical system and everything else in the state system - government, universities, etc., were self insured so the spat did't affect state employees). As that is one of the more popular employee insurers around here the crisis created was pretty big.

 

[riders_onthestorm]

Greed . . . is good - Gordon Gecko

right away Mr. Gecko