US Judge Approves Blue Cross’ $2.8B Settlement to Healthcare Providers

A US Judge has given the green light for Blue Cross Blue Shield (BCBS) to pay $2.8 billion in reimbursements to healthcare providers and professionals, in an attempt to end a 12-year dispute over the insurer’s alleged underpayment for their services.

Reports on Thursday said that Judge Robert David Proctor of the US District Court for the Northern District of Alabama tentatively approved a request by BCBS to pay $2.8-billion in reimbursements to healthcare providers and professionals for their services that were allegedly underpaid.

The settlement was touted as the largest ever for a healthcare antitrust case.

Proctor called the monetary award “extraordinary” and said that it would improve healthcare providers’ ability to recover payment for their services.

According to Proctor, part of the settlement included changes and improvements to claims that providers have been attempting to secure from BCBS for decades. This included creating a system-wide, cloud-based platform for verifying claims eligibility and tracking.

The plaintiffs initially sued BCBS in 2012, claiming that the company and its affiliates violated an antitrust law by dividing the country into exclusive areas where they agreed not to compete with each other.

According to the lawsuit, the lack of competition led to higher insurance costs and drove down provider reimbursement.

BCBS denied the allegations but agreed to the settlement to make operational changes so that it could put the years of dispute behind it.

Joe Whatley and Edith Kallas, lead attorneys for the class of healthcare professionals, welcomed the court’s ruling, saying that the deal will improve health insurance transparency, efficiency, and accountability.

According to Reuters, BCBS did not respond to its request for comment on the approved ruling.

In 2020, BCBS separately agreed to pay $2.7 billion to resolve antitrust claims from commercial and individual subscribers. BCBS companies and affiliates were required to eliminate an association rule that mandated two-thirds of national net revenues from health plans and related services to come from Blue-branded products.

The US Supreme Court upheld such settlement in June.

Meanwhile, groups of out-of-network emergency services providers raised concern about the scope of the new accord, telling Proctor that they have pending lawsuits against Blue Cross in Virginia and Florida “seeking significant reimbursement” for alleged underpayment for out-of-network emergency medical services.

Proctor said any opponents to the settlement can still lodge challenges before the court decides on its final approval. The judge has set a final fairness hearing for July 16, 2025.