Doug Wolfe, a partner at Wolfe Pincavage
Photo: Courtesy Wolfe Pincavage
Tuesday, March 4, is the deadline for hospitals to decide whether to opt out of a $2.8 billion Blue Cross Blue Shield antitrust settlement, according to Doug Wolfe, a partner at Wolfe Pincavage in Miami, Florida.
Hospitals must affirmatively opt out by March 4 to avoid being subject to the settlement’s release, he said.
WHY THIS MATTERS
The downside of participating is ambiguity over whether the release extends to claims in the ordinary course of business, Wolfe said. Hospitals may not fully understand what rights they are relinquishing by participating in the settlement.
“It’s not necessarily the right thing for hospitals,” he said. “What I want hospitals to do is make an informed decision.”
BCBS, which was accused of dividing up the country into geographic markets, has admitted no wrongdoing. The case that began at least four years ago was settled in October 2024 in federal court in Alabama.
The settlement applies to all healthcare providers who treated BCBS patients between July 24, 2008, and Oct. 4, 2024.
The $2.8 billion settlement is the gross amount to be distributed. After lawyers and other legal fees and costs, Wolfe estimates there’s $1.7 billion left to be divided among an estimated 6,000 health systems and hospitals.
The math works out to about $300,000 to $500,000 per hospital, based on the volume of claims submitted, he said.
Wolfe’s firm represents hospitals that have claims issues with insurance companies.
“Now March 4 is the deadline hospitals need to decide whether to opt out or not,” Wolfe said. “All hospitals are included unless they opt out.”
The settlement resolves claims that BCBS insurers violated antitrust laws by entering into an agreement not to compete with each other and to limit competition among themselves in selling health insurance, according to the BCBS settlement website.
THE LARGER TREND
This case is separate from a $2.67 billion class action antitrust settlement related to individuals. The deadline for individuals to file a claim was Nov. 5, 2021.
The $2.67 billion settlement fund is worth approximately $1.9 billion after deducting attorney fees and administrative costs, according to CBS News. The settlement payments are expected to be around $333 per claim to roughly 6 million claimants.
In 2021, millions of Blue Cross and Blue Shield beneficiaries received notices that they could be eligible for a share of a $2.7 billion antitrust.
Checks started going out in February on a rolling basis, according to Blue Cross Blue Shield.
The class included anyone who was covered by certain BCBS health insurance or administrative services plans between February 2007 and October 2020.
On June 24, 2024, the Supreme Court denied an appeal of the Eleventh Circuit Court of Appeals decision affirming approval of the Settlement Agreement. All appeals are resolved, according to BCBS.
Email the writer: [email protected]
link