Blue Cross Blue Shield has received preliminary approval for a groundbreaking $2.8 billion settlement aimed at resolving longstanding claims from hospitals, physicians, and other healthcare professionals alleging underpayment for services. U.S. District Judge R. David Proctor, in a ruling issued Wednesday, described the settlement as “extraordinary,” noting its potential to significantly improve providers’ ability to recover rightful payments.
The lawsuit, originally filed in 2012, accused Blue Cross and its affiliates of violating antitrust laws by dividing the U.S. into exclusive regional areas, thereby preventing competition among themselves. This alleged arrangement drove up insurance costs and reduced reimbursements to health providers, leading to years of legal battles.
Judge Proctor recognized that the settlement would have long-lasting benefits, not only through the financial compensation but also through changes in business practices designed to improve transparency, efficiency, and accountability in the health insurance system. This marks the end of over a decade of litigation and stands as one of the largest antitrust settlements in the U.S.
Joe Whatley and Edith Kallas, the lead attorneys for the class of healthcare professionals, expressed their satisfaction with the court’s decision. “This settlement caps over 12 years of litigation, offering substantial compensation for healthcare providers who have long been seeking better reimbursement for their services. Moreover, the structural changes in Blue Cross’ business practices will pave the way for increased transparency and fairness in the insurance industry,” they said in a statement.
In addition to the financial settlement, Blue Cross has agreed to implement a cloud-based platform for verifying claims eligibility and tracking reimbursements across its network. This platform, according to Judge Proctor, will address longstanding issues that providers have sought to fix with the Blues for decades.
While the settlement is a step forward, some out-of-network emergency services providers have raised concerns about its scope, particularly in relation to their ongoing lawsuits for underpayments in Virginia and Florida. However, Judge Proctor clarified that any objections to the settlement could still be raised before final approval is granted. A final fairness hearing has been scheduled for July 16, 2025.
Blue Cross Blue Shield previously agreed to pay $2.7 billion in 2020 to settle similar antitrust claims related to its commercial and individual subscribers. That settlement was upheld by the U.S. Supreme Court in June.
Blue Cross Blue Shield has not made any public statements regarding the settlement, but it has consistently denied any wrongdoing, stating that its decision to settle was made to avoid prolonged litigation.
The case is part of the ongoing legal proceedings known as In re: Blue Cross Blue Shield Antitrust Litigation, U.S. District Court for the Northern District of Alabama, No. 2:13-cv-20000-RDP.
Read more:
California Bar Will Evaluate Protest Participation In Lawyer Licensing Process
Yelp Calls For Appeals Court To Block Texas Lawsuit Over Crisis Pregnancy Center Reviews
Rockville Centre Catholic Diocese Reaches $320 Million Settlement for Sex Abuse Victims