By Mike Scarcella
(Reuters) -Insurer Blue Cross Blue Shield has agreed to pay $2.8 billion to resolve antitrust class action claims from hospital systems, physicians and other health care providers who allege they were underpaid for reimbursements, plaintiffs said on Monday in a filing in federal court in Alabama.
The settlement is the largest ever in a health care antitrust case, she added.
Blue Cross Blue Shield denied the allegations in a statement but said it agreed to the settlement and was making operational changes to “put years of litigation behind us.”
The providers’ lead attorneys, Joe Whatley and Edith Kallas, said in a statement that the proposed settlement would “transform” the BlueCard program through which providers file claims.
The agreement must still be approved by U.S. District Judge R. David Proctor.
The health care providers first sued in 2012, claiming that Blue Cross and its subsidiaries divided the land into exclusive areas where they did not compete with each other. The lawsuit stated that the nationwide conspiracy increased the cost of insurance and decreased reimbursement.
Under the settlement, Blue Cross will create a system-wide information platform that will enable member benefits, eligibility verification and claims tracking. According to the lawyers, this would lead to more transparency, efficiency and accountability.
The settlement also gives providers more contract options with the Blue Cross.
Blue Cross will spend hundreds of millions of dollars to implement the non-monetary portion of the settlement, the filing said.
The settlement covers US healthcare providers, including hospitals and some physicians, with Blue plan patients between July 2008 and October 2024.
The lawyers said they would seek up to $700 million in legal fees from the Blue Cross.
Blue Cross agreed in 2020 to pay $2.7 billion to resolve related antitrust claims from commercial and individual subscribers. The U.S. Supreme Court upheld that deal in June.