BCBS of Louisiana to face antitrust suit over rates

A Louisiana appeals court ruled that Blue Cross and Blue Shield of Louisiana must face a 2016 lawsuit over rate reimbursements, according to an opinion released Feb. 14. 

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The initial lawsuit, which seeks class action status, was brought by Opelousas General Hospital Authority in 2016. In it, the hospital authority alleges Blue Cross and Blue Shield of Louisiana violated antitrust laws by leveraging discounted rate reimbursements created by its BlueCard Program. 

The program allows Blue Cross Blue Shield members to receive care from facilities in other states at a discounted rate, according to the lawsuit. When a patient visits a facility outside of its plan’s network but in-network with another Blue Cross Blue Shield affiliate, they pay a rate equivalent to those negotiated with in-network providers in their state’s plan. 

The payer attempted to dismiss the lawsuit, but the court sided with the plaintiffs. The current ruling also sides with plaintiffs, and means that Blue Cross and Blue Shield of Louisiana must continue to face the matter in court.

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