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BumRushDaShow

(142,403 posts)
Sun Oct 20, 2024, 04:50 AM Oct 20

Insurer Blue Cross Blue Shield agrees to $2.8bn antitrust settlement

Source: The Guardian

Sat 19 Oct 2024 11.06 EDT
Last modified on Sat 19 Oct 2024 18.42 EDT


US insurer Blue Cross Blue Shield has agreed to pay $2.8bn to resolve antitrust class-action claims by hospital systems, physicians and other health providers alleging they were underpaid for reimbursements, the plaintiffs said in an Alabama federal court filing recently. The settlement is the largest ever for a healthcare antitrust case, they added.

Blue Cross Blue Shield denied the allegations in a statement but said it agreed to the settlement and to make operational changes to “put years of litigation behind us”. The providers’ lead attorneys, Joe Whatley and Edith Kallas, said in a statement the proposed settlement would “transform” the BlueCard program through which providers submit claims. The agreement is subject to approval from US district judge R David Proctor.

The health providers first sued in 2012, claiming Blue Cross and its affiliates divided the country into exclusive areas where they did not compete with each other. The lawsuit said the nationwide conspiracy increased the cost of insurance and drove down reimbursements.

Under the settlement, Blue Cross will create a system-wide information platform facilitating member benefits, eligibility verification and claims tracking that the attorneys said would lead to more transparency, efficiency and accountability. The settlement will also give providers more contracting opportunities with Blue Cross.

Read more: https://www.theguardian.com/us-news/2024/oct/19/insurer-blue-cross-blue-shield-agrees-to-28bn-antitrust-settlement



Link to AGREEMENT (PDF) - https://fingfx.thomsonreuters.com/gfx/legaldocs/zdpxqomowvx/Blue%20Cross%20provider%20class%20settlement%2020241014a.pdf
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OldBaldy1701E

(6,362 posts)
1. Let me guess...
Sun Oct 20, 2024, 06:31 AM
Oct 20

No admission of guilt? That seems to be the norm these days. Greed and obfuscation as their business model and when one is caught, act like it was an error and therefore they should not be publicly castigated for it. Even though they repeatedly committed the act and are finally being held to account for it.

We need to remove the practice of allowing those who are guilty to 'hide' their guilt from the population. It is a travesty of justice to keep on doing this.

poozwah

(276 posts)
4. yeah, right!
Sun Oct 20, 2024, 09:06 AM
Oct 20

they did nothing wrong and agreed to pay all this money to put this unpleasantness behind them, right? what a crock of shit! insurance companies now have a reputation worse than used car salesmen.

24601

(4,017 posts)
10. Unlike in criminal courts, cases do not determine guilt where a very high standard of "beyond a reasonable doubt" is
Sun Oct 20, 2024, 01:31 PM
Oct 20

normal. Civil cases instead determine responsibility or liability, usually by a preponderance of evidence—anything weighing over 50%.

moniss

(5,752 posts)
2. If I'm not mistaken there is a similar suit by
Sun Oct 20, 2024, 07:36 AM
Oct 20

the insured individuals as plaintiffs which has the settlement also in the billions of dollars and is working it's way through the acceptance process. Insureds who were cheated by excess premiums would have received money by now but Home Depot intervened with a legal challenge and appeals claiming the settlement would harm them by potentially affecting their future insurance costs as an employer. Thankfully they lost and now the final stages about costs, fees etc. have been taking place. So maybe over a decade after it was filed people might get some of their money back.

OldBaldy1701E

(6,362 posts)
5. Too profitable for those who are raking it in to change. And, they control the majority of the assets. (n/t)
Sun Oct 20, 2024, 09:46 AM
Oct 20

republianmushroom

(17,652 posts)
6. ...denied the allegations in a statement but said it agreed to the settlement and to make operational changes...
Sun Oct 20, 2024, 10:59 AM
Oct 20

$2.8 billion, oh yea, monthly premiums going up.

moonshinegnomie

(2,916 posts)
8. I'd go after insurance execs harshly
Sun Oct 20, 2024, 11:30 AM
Oct 20

Insurance denies coverage and a person dies?? Arrest the top execs for manslaughter or murder.
I’d go further too. Doctor commits Medicare fraud. They are no longer eligible for Medicare
Drug company gouges Americans by selling drugs multiple times the price in the rest of the world? They lose their patent
And so on

Magoo48

(5,361 posts)
11. Fuck um' and all the rest of the crooks in their nasty, criminal long con.
Sun Oct 20, 2024, 02:01 PM
Oct 20

Too much? Nawww,

Take 25% of the War Department budget, and fire up Single Payer, Universal healthcare. It will be the best investment we’re made in decades.

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