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Blues Agree To Settle With Physicians

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The Blue Cross and Blue Shield Association and a group of 23 Blue Cross and Blue Shield plans have negotiated an agreement that should help them resolve litigation with lawyers representing hundreds of thousands of doctors.

The BCBSA and the participating Blues plans have agreed to pay about $128 million into a general settlement fund for the physician plaintiffs, and they may end up paying up to $49 million in legal fees, according an announcement released by the participating plans.

The BCBSA and the plans also have agreed to take steps to improve communications with physicians and do more to cooperate with them, the plans say.

The Blue Cross and Blue Shield carriers participating in the agreement provide health coverage for tens of millions of Americans.

In the late 1990s, lawyers filed a wave of suits accusing the settling plans and other health carriers of working together to lower and delay payments to doctors in unreasonable ways.

In 2003, the courts consolidated the litigation against the Blues plans, now known as the Thomas-Love litigation, in Miami under U.S. District Court Judge Federico Moreno.

“Each of the settling plans and the BCBSA made an independent decision that this agreement is in the best interest of the settling plans,” Michael Pope, a spokesman for the settling plans, says in a statement about the settlement agreement.

The American Medical Association, Chicago, put out a statement praising the Blues plans for agreeing to the proposed settlement.

The plans’ move will “fundamentally shift how their system conducts business with physicians,” AMA President Dr. William Plested says in the AMA statement.

The group of settling Blues plans includes:

- Blue Cross and Blue Shield of Alabama.

- CareFirst Inc. and CareFirst of Maryland Inc.

- Group Hospitalization and Medical Services Inc.

- Blue Cross and Blue Shield of Florida.

- Hawaii Medical Service Association.

- Health Care Service Corp.

- Wellmark Inc., along with Wellmark Blue Cross and Blue Shield of Iowa and Wellmark of South Dakota Inc.

- Louisiana Health Services & Indemnity Company, which does business as Blue Cross and Blue Shield of Louisiana.

- HMO Louisiana Inc.

- Blue Cross and Blue Shield of Massachusetts.

- Blue Cross Blue Shield of Michigan.

- Blue Cross and Blue Shield of Minnesota.

- Blue Cross & Blue Shield of Mississippi

- HMO of Mississippi.

- Blue Cross and Blue Shield of Montana.

- Horizon Blue Cross Blue Shield of New Jersey.

- Blue Cross and Blue Shield of North Carolina.

- Hospital Service Association of Northeastern Pennsylvania.

- Triple S Inc. of Puerto Rico.

- The Regence Group, along with Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah, Regence BlueShield (in Washington) and Regence BlueShield of Idaho.

- Blue Cross & Blue Shield of Rhode Island.

- BlueCross BlueShield of South Carolina.

- BlueCross BlueShield of Tennessee.

- Premera Blue Cross.

- Empire Blue Cross Blue Shield.


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