A federal judge has approved a $2.8 billion settlement resolving antitrust claims brought by healthcare providers against the Blue Cross Blue Shield Association and its independent entities, ending more than a decade of litigation.
The settlement was approved Aug. 19 and covers a class of millions of hospitals, physician practices, and other providers nationwide who accused the Blues of conspiring to divide up markets to avoid competing with one another, which allegedly drove up costs and reduced reimbursements.
Under the agreement, about $1.78 billion will be distributed to healthcare facilities, while $152 million is earmarked for medical professionals. The settlement also implements structural reforms valued at more than $17 billion, including how BCBS plans process claims, and how they communicate, contract with, and make payments to providers. The settlement applies to providers who treated BCBS members between July 2008 and October 2024.
“Blue Cross Blue Shield Association and Blue Cross and Blue Shield companies are pleased with the Court’s Order approving the settlement we reached to resolve the claims in this case,” a BCBS spokesperson told Becker’s. “As we move forward, we remain focused on the goal we have had for more than 90 years: improving access to high-quality, equitable and affordable healthcare for the people and communities we serve.”
In August, nearly 6,500 providers opted out of the settlement, including some of the nation’s largest health systems. The systems and other provider groups have filed new antitrust lawsuits against BCBS, alleging anti-competitive practices are still happening and continue to harm providers financially.
The $2.8 billion settlement follows another antitrust lawsuit from BCBS employer customers, first filed in 2012. In October 2020, BCBS companies and the association reached a nearly $2.7 billion settlement, in which BCBS admitted no wrongdoing. That settlement required BCBS companies to eliminate an association rule that mandated two-thirds of national net revenues from health plans and related services come from Blue-branded products. Another rule struck down by the settlement required large employers to work with the Blue insurer located where the employer was headquartered, preventing BCBS companies from competing for large contracts. The U.S. Supreme Court upheld that settlement in June 2024.
