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Blue Cross Blue Shield Antitrust Settlement — Key Implications for Health Care Providers

Published January 4, 2025

The In re: Blue Cross Blue Shield Antitrust Litigation (MDL No. 2406) represents a landmark antitrust class action suit addressing allegations that BCBS and its affiliated insurers engaged in anti-competitive practices. The case, under the jurisdiction of the U.S. District Court for the Northern District of Alabama, claimed that BCBS entities unlawfully divided geographic markets, limiting competition and suppressing provider reimbursement rates.In 2024, BCBS agreed to a $2.8 billion settlement. This settlement is pending before the Alabama District Court. The settlement includes substantial reforms affecting how BCBS-affiliated plans operate, with major implications for healthcare providers, employer-sponsored health insurance, and consumer choice.

Who Is Included in the Settlement?

The settlement covers health care providers across the U.S. who rendered services to patients insured by BCBS between July 24, 2008, and October 4, 2024. This includes individual practitioners, medical groups, hospitals and other health care facilities.

Exclusions from the Settlement

Certain providers are not eligible for compensation, including:

  • Providers owned or employed by BCBS entities
  • Government-employed providers and those exclusively serving Medicare, Medicaid or the Federal Employee Health Benefits Program
  • Providers who have already fully settled claims against BCBS in prior litigation
  • Entities that solely provide prescription drugs, durable medical equipment, medical devices, independent lab services or standalone dental/vision services

Settlement Fund Distribution

The $2.8 billion settlement fund will be allocated as follows:

  • 92% to hospitals and health care facilities
  • 8% to medical professionals and organizations

Action Steps for Providers

Payment will be based on the total estimated Allowed Amounts from BCBS-affiliated plans during the settlement period. Compensation will be determined using a points-based system that factors in provider reimbursement levels and geographic harm coefficients.

Health care providers wishing to make a claim must submit a valid claim by July 29, 2025.

Providers desiring to be excluded from the Settlement Class and maintain their right to sue the defendants or to object to the settlement must make such a request or objection by March 4, 2025. Providers also can give up their right to sue and receive no payment by taking no action.

Providers can submit a claim and any required accompanying documentation online (strongly encouraged) or by mail to this address:

Blue Cross Blue Shield Provider Settlement
Settlement Notice Administrator

P.O. Box 26443
Richmond, VA 23261

The Court in charge of this case still has to decide whether to approve the Settlement. No payments will be made unless and until the Court approves the Settlement and any appeals are resolved.

For more details or to file a claim, visit the BCBS Antitrust Settlement website.

If providers have questions regarding any of the above information, they should seek legal counsel.

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