Court approves $2.8B BCBS class-action settlement; insurer to make changes
In October 2024, it was announced that Blue Cross Blue Shield (BCBS) had agreed to pay $2.8 billion to end an antitrust lawsuit brought by numerous hospitals and providers who alleged the nonprofit insurer failed to reimburse patient care.
BCBS was also accused of stonewalling contract renegotiations, forcing some practices to leave their network. This contributed to instances of underpayment, the plaintiffs argued.
On Tuesday, the lawsuit came to an end when a judge approved the settlement. Per the ruling from Chief U.S. District Court of Alabama Judge R. David Proctor, a fund will be established from which class members can collect payments.
According to court documents, there could be as many as 3 million class members, each of whom is eligible for a share of the $2.8 billion. Attorney fees—which Proctor approved at $657.1 million, including expenses—will be charged to the insurer and paid separately.
BCBS continues to maintain it did nothing wrong and admits no guilt. In a statement, the company said it’s focused on “improving access to high-quality, equitable and affordable health care for the people and communities we serve,” and was happy to put an end to “years of litigation.”
However, related antitrust cases against the insurer are still pending, as not all hospitals joined the class-action due to the unique circumstances of their claims.
Changes coming to BCBS BlueCard
Many of the complaints stem from patients covered by BCBS BlueCard health plans, used by many of the insurer’s affiliates to cover in-network care. As part of the settlement, BCBS will create a national data platform to better track in-network status and medical claims.
The goal of the new platform is to streamline reimbursement and reduce the number of denied claims. Both BCBS and the class-action plaintiffs agreed to the platform’s creation.
The lawsuits date back as early as 2021, with grievances extending to 2008.
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