© 2020 by Nordic Star Law. All rights reserved. No Attorney Client Relationship. 

Recent Posts

Health care provider class attorneys on Tuesday alerted an Alabama federal judge to recent Anthem Corp. testimony in Delaware that they say contradicts Blue Cross Blue Shield Association denials that the group’s rules, including nationwide limits on member revenues from “non-Blue” businesses, are anticompetitive.

The concern appeared in a notice filed in a multidistrict litigation antitrust case against BCBS companies in the U.S. District Court for the Northern District of Alabama. The notice recapped developments during a 10-day Chancery Court trial over dueling da...

The “strategic affiliation” of two health insurers that operate Blue Cross and Blue Shield plans in five states makes it more difficult for Anthem to expand using the valuable Blues brand in new markets.

Cambia Health Solutions and Blue Cross and Blue Shield of North Carolina (Blue Cross NC) said this week the are forming a “strategic affiliation” that merges operations and management of two companies operating Blues plans on the East and West coasts.

That makes it less likely the larger Cambia wants to sell to the publicly-traded, investor-owned Anthem, which i...

Tie-up brings together health-care players with combined $16 billion in revenue, covering over six million people.

Cambia Health Solutions and Blue Cross and Blue Shield of North Carolina will merge their managements in a combined structure that will retain the Cambia name. The two not-for-profits said they aim to bolster their investments and speed progress in developing new health-data approaches and consumer tools, among other areas.

The move will draw close national attention because both are members of the Blue Cross Blue Shield group of insurers, which include...

Health Care Service Corp., which operates Blue Cross Blue Shield plans in a handful of states, did not pay any federal taxes in 2018 and received a $1.7 billion tax refund, according to its latest financial report.

The tax refund boosted the health insurance conglomerate's net profit to $4.1 billion last year, compared to $1.3 billion in 2017, according to Axios, which first reported about Health Care Service's tax refund.

Axios noted that Health Care Service was one of the biggest beneficiaries of the GOP tax cut and has experienced rising profit...

The top boss at Blue Cross Blue Shield of Michigan has reached the pinnacle of executive pay in Michigan, getting more in total compensation than CEOs at several bigger for-profit companies across the state.

Blues CEO Daniel Loepp, 61, who received $19.2 million in total compensation last year — a record for Michigan's largest insurance company — is also one of the highest-paid bosses of any health insurer in the nation.

Loepp's compensation, disclosed a week ago, has not drawn much scrutiny from public officials...

An Atlanta-based law firm filed a federal class-action lawsuit Tuesday against Anthem Inc./Blue Cross and Blue Shield of Georgia Inc.

The Doss Law Firm, representing two Cobb County residents, charged the insurance giant with misleading thousands of Georgia consumers during last fall's open-enrollment period into believing they would continue to have access to the doctors and specialists of WellStar Health Systems Inc.

The case involves Georgians who enrolled in Anthem's Pathways health insurance plan, which is offered on the individual health insurance exchange crea...

A group of more than 180 ASCs requested a federal court's final approval of a $4 million settlement with Horizon Blue Cross Blue Shield of New Jersey, Law360 reports.

Here are six insights:

1. The suit, which was initiated 13 years ago regarding Horizon's out-of-network reimbursement practices, accuses the payer of making improperly low reimbursements on medical claims in violation of the Employee Retirement Income Security Act. The suit includes two subclasses — Navigant and the Student Employee Health Plan.

2. The centers have already received more than $150 million...

The Fifth Circuit Appellate Court has revived a Texas hospital's $58 million lawsuit against 16 independent insurers and claims administrators doing business under the Blue Cross and/or Blue Shield trademarks across the U.S. over alleged underpayments.

Here are 10 things to know about the lawsuit:

1. In 2012, Victory Medical Center-San Antonio (Texas), previously Innova Hospital San Antonio, sued the BCBS independent insurers and claims administrators in Texas state court. In the lawsuit, which was removed to federal court, the hospital alleged the insurers failed to...

A federal judge in Alabama overseeing a case involving 36 Blue Cross plans ruled Thursday a 1980s-era plan to divvy up service areas may violate antitrust laws, a finding attorneys said is a major blow to the companies' case.

The ruling is not final, but does provide a lens for the judge to use as the case goes to trial, said plaintiff's attorney Barry Ragsdale. The 2013 lawsuit, filed by providers and small-group subscribers, accuses the plans and the Blue Cross Blue Shield Association of violating antitrust laws that keep businesses from conspiring to affect the m...

A leading health insurance group said Monday there is an “urgent” need for Congress to act to stabilize ObamaCare markets after the repeal of the individual mandate in December.

“There’s an urgent need to stabilize the market,” Justine Handelman, a senior vice president at the Blue Cross Blue Shield Association, told reporters at a briefing.

She said the most important action Congress could take is to provide funding for what is known as reinsurance, which helps cover the costs of especially sick patients, thereby bringing down premiums.

“Without the mandate we think...

In a move that could impact life-or-death deliberations of millions of Americans, Anthem Blue Cross and Blue Shield affiliates throughout the country are implementing tough new guidelines for determining whether to cover emergency room visits by their policyholders. 

With the cost of hospital emergency room services ballooning and many uninsured or poor people turning to ER’s for routine medical care, Blue Cross and Blue Shield affiliates in at least four states – New York, Missouri, Kentucky, and Georgia – are adopting new policies that would cover only emergency r...

Please reload

Please reload

Archive