Judge removes some physicians from Blue Cross Blue Shield antitrust lawsuit

Some physicians were removed from an antitrust lawsuit against Blue Cross Blue Shield, due to the wording of previous settlement agreements.

The case stems from a group of physicians who filed a class-action lawsuit in 2003, alleging that the insurer systematically denied, delayed and diminished payments. It led to four separate settlements, which resulted in BCBS paying $384 million in cash and spending more than $535 million to change their business practice.

Two of the four settlement agreements, named by BCBS as WellPoint and Capital, did not contain carve-out provisions that would allow physicians to recoup damages from ongoing litigation involving BCBS' BlueCard Program, the billing infrastructure that's allegedly at the heart of the antitrust suit.

"Therefore, the Love providers' damages claims, like their injunctive relief claim, are barred by the release provisions of the WellPoint and Capital settlement agreements, and there is no BlueCard exception to save them," Alabama federal judge David Proctor wrote in a partial summary judgment Wednesday. Dr. Rick Love, the late otolaryngologist who practiced in Alabama, was part of the group of physicians who filed the initial lawsuit.

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BCBS said in a statement that it does not comment on pending litigation.

BCBS faces a consolidated lawsuit that's divided into separate tracks involving claims by physicians and BCBS members. Some patients with BCBS coverage opted out of the landmark $2.67 billion settlement reached in 2020, resolving claims that BCBS entities conspired to not compete with each other for customers, which reduced competition and reimbursement.

A Louisiana appeals court ruled Monday that Blue Cross and Blue Shield of Louisiana must face a separate class-action trial to settle hospitals' allegations that BCBS used its BlueCard Program to limit reimbursement rates.