The landmark Blue Cross Blue Shield (BCBS) antitrust settlement brought by Whatley Kallas, LLP, will deliver more than just the $2.8 billion in monetary compensation to class members. The settlement also requires BCBS to invest millions in transformative system improvements that enhance accountability, streamline claims processing, and reduce administrative burdens for healthcare providers through significant reforms to the BlueCard Program. We are delighted to welcome Jeffrey Gold, Special Counsel of the Managed Care and Insurance division at the Healthcare Association of New York State (HANYS) as a guest author in our managed care blog series. He shares his insights into how the multi-billion dollar settlement and its Blue system transformation will benefit providers for years to come. https://lnkd.in/gF2pSpvQ
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These keep coming and will likely dramatically increase come January. Y'all need to go get compliant, fast! Many multi-location brands and franchise systems are implementing or considering implementing a centralized system for marketing to give to their agents/locations to use, that's locked down and compliant for lead-generation. And, they're considering mandating its use and prohibiting any other lead gen marketing or purchasing. I don't know how else you comply. Dustin Owen, CMB®, AMP and I just talked about this #tcpa impact on a webinar! If you need it, Evocalize can help. But regardless, follow TCPAWorld.com from Eric J. Troutman & team (Troutman Amin LLP), and please spread the word.
Czar of the TCPA, Tsar of the TSR, Telecom Attorney, Partner Troutman Amin, LLP, Founder TCPAWorld.com, Founder and President R.E.A.C.H, True Romantic
in case you missed it, Blue Cross NC just settled a TCPA class action for $1.6MM for robocalls allegedly made by Change Healthcare without consent. 1400 class members here so about $100.00 a head. Class counsel should make about $500k. So it goes... #tcpa #settlement #deservetowin
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Blue Cross Blue Shield recently reached a $2.8 billion settlement in a landmark antitrust lawsuit with healthcare providers. This 12-year case highlighted allegations that BCBS limited competition, imposed administrative burdens, and underpaid providers for services. Providers who treated BCBS members from 2008 to 2024 can file claims for their share. Operational reforms, such as faster claim payments and more transparent benefit processes, will be implemented. Providers must decide whether to join the settlement or opt out to pursue their own claims. This settlement not only compensates providers but also sets the stage for critical changes in how BCBS operates. While many see this as a victory for providers, concerns remain about fair representation for out-of-network providers. #medicalclaims #antitrust #insurnace #fiduciary #healthinsurance us-beacon.com https://lnkd.in/gxXjarZC
A nearly $3 billion settlement with Blue Cross Blue Shield leaves providers with a big choice
https://www.hfma.org
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Healthcare Revenue Cycle | Client Dedication | Patient Journey & Financial Clearance | Past-President HFMA Denials ⬇️ | Patient Engagement ⬆️| Revenue ⬆️| Wakefield🗝️
Providers contracted with BCBS (2008) should evaluate the potential impact of a historic $2.8 billion settlement—the largest antitrust agreement in U.S. healthcare. Transparency, claims management, and out-of-network contracting improvements are on the horizon(?), but providers must decide whether to participate or pursue individual claims for triple damages. Claw back some lost revenue!
A nearly $3 billion settlement with Blue Cross Blue Shield leaves providers with a big choice (updated)
https://www.hfma.org
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We’ve been fielding a lot of questions about what the BCBSA settlement means for providers and whether opting in or out makes the most sense. This article has some considerations regarding the settlement for you to consider.
Blue Cross Blue Shield reached a $2.8 billion settlement in an antitrust class action to resolve allegations of suppressed competition and underpayment to providers. This landmark settlement follows earlier agreements with subscribers and is set to reimburse health systems, hospitals and other providers who treated BCBS patients between 2008 and 2024. Hall Render attorneys Michael R. Greer, Nathan Chubb and Liliann Stoll discuss the details in a Law360 article here: https://lnkd.in/g4twUCBT
Next-Steps-In-The-2.8B-Blue-Cross-Payout-To-Providers-Law360-Hall-Render-Article.pdf
webdocs.hallrender.com
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Pre-payment reviews have become a significant issue for healthcare providers, leading to delayed reimbursements and potential legal risks. Horizon Blue Cross Blue Shield of New Jersey (“Horizon”) has been particularly problematic with its "Claim Pattern Review Program," targeting high-value procedure codes. In a new article, Frier Levitt attorneys Guillermo Beades and Phoebe A. Nelson provide an overview of pre-payment reviews, how they impact providers, and Horizon’s concerning audit trends. Additionally, learn how to protect your practice and the crucial role of legal guidance. Read here: https://lnkd.in/dURGdrjF #FrierLevitt #PrepaymentReviews #HealthcareAudits #ProcedureCodes
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Value based healthcare …. Is valuable only for the health insurers
$3bn SETTLEMENT: Blue Cross Blue Shield is set to pay a record-breaking $3 billion to settle allegations of colluding to cheat doctors and hospitals —practices that drove up costs for everyone. This is the largest settlement in U.S. healthcare history, and it shines a spotlight on how insurers prioritize profits over fair treatment for providers and patients. This case is a powerful reminder of how litigation can expose unethical behavior and force meaningful change. But the fight isn’t over — stay tuned as we continue to cover how this impacts healthcare providers, patients, and the system as a whole.
$3 Billion Wake-Up Call: How Litigation Is Holding Insurers Accountable
healthcareuncovered.substack.com
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Healthcare Subject Matter Expert & Salesforce Health Cloud Project Manager/Business Analyst | Medical Revenue Cycle Optimization for Salesforce | 20+ Years in Healthcare, Operations & Small Business Leadership
When you also consider the market share BCBS has in the state of Alabama this is a big deal.
$3bn SETTLEMENT: Blue Cross Blue Shield is set to pay a record-breaking $3 billion to settle allegations of colluding to cheat doctors and hospitals —practices that drove up costs for everyone. This is the largest settlement in U.S. healthcare history, and it shines a spotlight on how insurers prioritize profits over fair treatment for providers and patients. This case is a powerful reminder of how litigation can expose unethical behavior and force meaningful change. But the fight isn’t over — stay tuned as we continue to cover how this impacts healthcare providers, patients, and the system as a whole.
$3 Billion Wake-Up Call: How Litigation Is Holding Insurers Accountable
healthcareuncovered.substack.com
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Facts 1. Hospital reimbursement up 2. Hospital administration salaries up. 3. Average hospital CEO salary up a. from 2005 to 2015, the average compensation of major nonprofit hospital CEOs jumped 93% from $1.6 million to $3.1 million, while average hospital worker wages increased just 8%. 4. Insurance company salarirs and profits up 5. Doctors work load at all time high. 6. Patient wait times high and unacceptable 7. Physician workforce declining 8. Doctors salaries down 9. Doctor burnout at all time high 10. Doctor dissatisfaction at all time low At some point, physicians and patients are going to wake up and use their leverage appropriately! Maybe we should stop expressing our ideology and start defending our healthcare!
$3bn SETTLEMENT: Blue Cross Blue Shield is set to pay a record-breaking $3 billion to settle allegations of colluding to cheat doctors and hospitals —practices that drove up costs for everyone. This is the largest settlement in U.S. healthcare history, and it shines a spotlight on how insurers prioritize profits over fair treatment for providers and patients. This case is a powerful reminder of how litigation can expose unethical behavior and force meaningful change. But the fight isn’t over — stay tuned as we continue to cover how this impacts healthcare providers, patients, and the system as a whole.
$3 Billion Wake-Up Call: How Litigation Is Holding Insurers Accountable
healthcareuncovered.substack.com
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Wondering where your premium increases are going?? 🤔 Employers are paying more and more to insure their employees and getting less and less care!! If there ever was a time for #directprimarycare it’s now!! Had a call today with a company to help them understand how a healthplan designed around #DPC can save up to 30% on their healthcare spending! When was the last time you saved money on healthcare?? 🤔
$3bn SETTLEMENT: Blue Cross Blue Shield is set to pay a record-breaking $3 billion to settle allegations of colluding to cheat doctors and hospitals —practices that drove up costs for everyone. This is the largest settlement in U.S. healthcare history, and it shines a spotlight on how insurers prioritize profits over fair treatment for providers and patients. This case is a powerful reminder of how litigation can expose unethical behavior and force meaningful change. But the fight isn’t over — stay tuned as we continue to cover how this impacts healthcare providers, patients, and the system as a whole.
$3 Billion Wake-Up Call: How Litigation Is Holding Insurers Accountable
healthcareuncovered.substack.com
Creative Director/Content Creation
6dThis is a huge win for Americans. Bravo 👏