Originally appeared on the Reuters website February 1, 2024
By Mike Scarcella
Feb 1 (Reuters) - Blue Cross Blue Shield Association must face claims that it schemed with affiliates for years to underpay healthcare providers by billions of dollars, a federal judge in Birmingham has ruled.
U.S. District Judge R. David Proctor in a ruling, opens new tab on Wednesday said non-hospital health providers in the state could proceed toward a trial, marking the latest blow to Blue Cross in the long-running litigation.
Dozens of insurance subscriber and healthcare provider cases were centralized in Alabama a decade ago as part of a multidistrict litigation proceeding. The lawsuits alleged a conspiracy among Blue Cross and its members to curb competition, driving up the cost of insurance and driving down reimbursements.
The providers "presented evidence of actual injury as a result of the alleged conspiracies,” Proctor said in denying Blue Cross's bid for summary judgment.
Proctor had previously allowed claims from more than 100 hospitals in Alabama to move forward to trial.
Blue Cross had argued, opens new tab that non-hospital health providers failed to show any alleged harm and also any “reliable estimate” of damages.
A spokesperson for the insurance association declined to comment on Thursday.
A lawyer for the health providers, Joseph Whatley, said on Wednesday that the decision clears the path for trial.
“We look forward to presenting all the issues for all healthcare providers to a jury,” Whatley said. The court has not set a trial date.
Experts for the Alabama hospital plaintiffs have estimated that they suffered more than $5 billion in damages, court filings show. The non-hospital providers have not specified their individual damages.
The healthcare providers' claims was part of broader litigation against Blue Cross and its affiliates over their business practices.
A class of insurance subscribers, including individuals and companies, settled related claims against Blue Cross for $2.7 billion in 2020.
That settlement won approval last year in the Atlanta-based 11th U.S. Circuit Court of Appeals.
The case is In re Blue Cross Blue Shield Antitrust Litigation, U.S. District Court for the Northern District of Alabama, No. 2:13-cv-20000-RDP.
For provider plaintiffs: Joe Whatley Jr and Edith Kallas of Whatley Kallas
For Blue Cross Blue Shield Association: Karin DeMasi and Evan Chesler of Cravath, Swaine & Moore
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