Blue Cross Blue Shield Association Settles Class-Action Lawsuit Filed By 900,000 Physicians

It appears Blue Cross is involved in quite a few law suits today....BD

Twenty-three Blue Cross Blue Shield Association plans nationwide on Friday announced the settlement of a class-action lawsuit filed by about 900,000 physicians over allegations that the plans improperly reduced their reimbursements, the Wall Street Journal reports. In the lawsuit, the physicians and their medical societies alleged that BCBS plans delayed or denied reimbursements for medical services and improperly rejected claims for necessary medical services.

Under the settlement, the BCBS plans will contribute $128 million to a fund to which physicians can submit previously disputed claims and pay as much as $49 million in legal fees. In addition, BCBS plans agreed to establish new external review boards to address disputed claims, make their fee schedules and reimbursement explanations more transparent, standardize definitions and review procedures used to determine whether services are medically necessary. The settlement requires approval from U.S. District Judge Federico Moreno in Miami (Fuhrmans, Wall Street Journal, 4/28).

Source: Blue Cross Blue Shield Association Settles Class-Action Lawsuit Filed By 900,000 Physicians