Blue Cross And Blue Shield Insurers Dealt Significant Legal Blow In Case Over Anti-Competitive Practices
The ruling makes it easier for providers and plan members to prove that the plans impede competition by offering insurance coverage in exclusive markets.
Modern Healthcare:
Blues Antitrust Case Just Got Tougher For The Insurers
A federal appeals court on Wednesday ruled that Blue Cross and Blue Shield insurers must defend themselves against a major class action case accusing them of anticompetitive practices on much less favorable legal grounds. The 11th U.S. Circuit Court of Appeals upheld a federal district judge's April ruling that the combination of the Blues plans' exclusive territories, in which they agreed not to compete, and the agreement to limit competition on non-Blues branded products is a per se violation of the Sherman Antitrust Act. (Meyer 12/12)
In other health industry news —
Bloomberg:
Health Insurance Feud That Threatened Surprise Bills Is Resolved
UnitedHealth Group Inc., the biggest U.S. health insurer, agreed to renew its contract with a large hospital staffing company after a months-long stand-off that threatened to put millions of people at risk of surprise medical bills. The contract between UnitedHealth’s insurance unit and Envision Healthcare, owned by private-equity giant KKR & Co., was set to expire Jan. 1. The companies announced the deal in separate press releases Tuesday morning. Representatives for UnitedHealth and Envision both declined to comment on details of the new agreement. (Tozi, 12/11)
Bloomberg:
J&J Is Said Willing To Pay $400 Million-Plus In Hip-Device Cases
Johnson & Johnson is willing to pay more than $400 million to settle some of the thousands of consumers’ allegations that the company sold defective artificial hips and hid the health risks of the devices, people familiar with the negotiations said. The world’s largest health-care products maker has settled, or is in the process of settling, about 3,300 of 10,000 lawsuits targeting its Pinnacle line of hip-replacement devices, a judge said in a Dec. 9 court filing. (Feeley, 12/12)
