Dozens of health systems file 'opt-out' antitrust lawsuits against Blue Cross Blue Shield
By Admin | March 05, 2025
Dozens of health systems and other provider groups have filed new antitrust lawsuits against the Blue Cross Blue Shield Association and its 33 independent entities, alleging anticompetitive practices that led to suppressed payments to providers.
The lawsuits, filed in March 4 in federal courts in in Pennsylvania, California and Illinois, come after hospitals and other providers opted out of a $2.8 billion class-action settlement reached in October 2024 with BCBS. Physician groups, surgery centers and home health providers have also joined as plaintiffs in the new complaint.
The plaintiffs claim that BCBS companies conspired to divide geographic markets, restrict competition, and fix reimbursement rates, thereby limiting providers' ability to negotiate fair contracts. The complaints allege that BCBS's longstanding territorial agreements prevented the insurers from competing with each other, in turn artificially lowering payments to hospitals and physicians.
The new "opt-out" lawsuits follow two major antitrust settlements involving BCBS in recent years. The first, a $2.67 billion settlement in 2020, resolved claims brought by employers and individual members who alleged BCBS companies colluded to avoid competing for large contracts. That settlement required BCBS to change its association rules, allowing large employers to seek...(More)
For more info please read, Dozens of health systems file 'opt-out' antitrust lawsuits against Blue Cross Blue Shield, by Becker's Payer Issues
