A federal judge has approved a $2.8 billion antitrust settlement between Blue Cross and Blue Shield carriers (“the Blues”) and healthcare providers. The settlement resolves the plaintiff healthcare providers’ claims that the Blues conspired to decrease provider payments. The final settlement, which the parties reached in October 2024, allows for about $657 million in attorneys’ fees and $102 million in litigation expenses. The Blues continue to deny any wrongdoing.
The Blues consists of 33 separate health coverage providers, some of which are nonprofit organizations and some of which are for-profit entities. Collectively, the Blues provide or administer health coverage for 118 million people and have a network of about two million healthcare providers.
The practical impact of the settlement for employers is potential changes to the BlueCard program. This program offers access to a national network of healthcare providers that accept prices and contract terms that the Blues have negotiated for employers who use them for fully insured group coverage or administration of self-insured plans. It is unclear specifically how the settlement will affect employers and plan participants using the BlueCard program, but it could make provider access and pricing more complex.
The plaintiffs first initiated lawsuits against the Blues based on antitrust allegations in 2012. In 2013, the federal cases were consolidated into a multidistrict litigation case in the U.S. District Court for the Northern District of Alabama. That court divided the cases into two groups: one for subscribers, including employers with fully insured plans and employers with self-insured plans, and one for healthcare providers, including facilities and individual professionals.
The court approved a $2.7 billion settlement for employers that participated in the litigation, or “subscriber plaintiffs,” in 2022. The provider class has about 3.3 million members, about 6,400 of whom have opted out of the provider settlement, including large healthcare systems such as the Mayo Clinic.
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