Medical providers, including individuals, physician groups, hospitals, surgery centers, health systems and other health care facilities, may be eligible for a portion of a $2.8 billion settlement reached by the Blue Cross...more
Now is the time for health care providers to consider participating in the recent Blue Cross Blue Shield (BCBS) antitrust class action settlement and the newly filed antitrust cases alleging widespread price fixing for...more
Welcome to the first issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice. In this issue, we cover Medicare Part C oversight, new cybersecurity legislation, healthcare lawsuits and deals, and...more
The battle over COVID-19 vaccine mandates is far from over. A Michigan federal jury recently awarded $12.69 million in damages to Lisa Domski, a former Blue Cross Blue Shield of Michigan (BCBS) employee, who claimed she was...more
On October 14, 2024, a class of hospitals, physicians, and other health care providers (Provider Plaintiffs) reached a proposed $2.8 billion settlement of antitrust claims against the Blue Cross Blue Shield Association and...more
Here are curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •FTC Accuses Cash-Advance App of Misleading Consumers - ...more
Minnesota AG Keith Ellison has reached a settlement with BCBSM, Inc. d/b/a Blue Cross and Blue Shield of Minnesota, and HMO Minnesota d/b/a Blue Plus (collectively, “Blue Cross”) to resolve allegations that the insurer...more
In October 2024, Blue Cross Blue Shield (“BCBS”) agreed to a $2.8 billion settlement to resolve allegations of anti-competitive practices in the health insurance market – it is reported to be the largest settlement in a...more
On October 14, 2024, a class of thousands of hospitals, physician groups and other healthcare providers filed a proposed settlement in a twelve-year antitrust lawsuit against the Blue Cross Blue Shield (BCBS) network. BCBS...more
In a major win for healthcare providers, on September 20th a Louisiana state court jury awarded $421 million in favor of an out-of-network provider in its long dispute with Blue Cross Blue Shield of Louisiana (“BCBS of...more
Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment - Defunct BestCare Laboratory Services LLC and its founder will pay $5.7 million to settle an outstanding 2018 False Claims Act...more
While an insurance carrier “labor[ed] valiantly” to rescue claims over $3.1 million in overpayments to a hospital in its network, the Business Court held it failed because the contract at issue “clearly and unambiguously”...more
Surgeon To Pay Up to $43 Million for FCA Fraud - A Michigan vascular surgeon, Vasso Godiali, was sentenced to 80 months in prison for defrauding health care programs in connection with his submission of false claims for...more
The Eliminating Kickbacks in Recovery Act of 2018 (EKRA) is a criminal statute that prohibits paying or receiving anything of value in exchange for the referral of patients to recovery homes, clinical treatment facilities, or...more
Earlier this month, the US District Court for the Western District of Washington certified a class of individuals who were denied gender-affirming care by a third-party administrator, Blue Cross Blue Shield of Illinois...more
This country’s relationship with cannabis is a complicated one, and as is often the case in complicated matters, words matter. Marijuana and hemp are different strains of the Cannabis sativa L plant. So, “cannabis” is a...more
Early Covid-19 Disability Ruling Offers Blueprint for Lawsuits - "The Montgomery, Ala.-based court is one of the first tribunals to weigh in on the issue." - Why this is important: As we enter into the third year of...more
A review of key legal developments for nonprofit organizations at the federal and state levels in 2020 and 2021. Antitrust Torrey v. Infectious Diseases Society of America, No. 17-190 (E.D. Tex. Sept. 1, 2021), No. 407 &...more
Attorneys Matthew M. Lavin and Aaron R. Modiano recently secured a complete denial of Blue Cross & Blue Shield of Michigan’s Motion to Dismiss a $40+ million dollar lawsuit brought on behalf of behavioral health providers for...more
For individuals who work with employer-sponsored benefit plans, the past 18 months has been packed with new developments from federal and state legislatures as well as executive branch initiatives and regulatory guidance....more
While too many of us get overdosed with clownish depictions - from doctors, hospitals, insurers, and corporations, especially Big Pharma firms - of how the civil justice system operates, it’s always worth a reminder of the...more
The year 2020 was an eventful one in the world of healthcare antitrust. The year began with the announcement of the precedent-setting settlement of the California Attorney General’s action against Sutter Health and ended with...more
Antitrust litigation has been ongoing for several years in the U.S. District Court for the Northern District of Alabama against one of the biggest business associations in America, the Blue Cross Blue Shield Association...more
Compliance Today (December 2020) - The Blue Cross Blue Shield insurance group has negotiated a possible settlement to sweeping antitrust lawsuits that alleged the group benefited from anticompetitive measures that...more
After over 8 years of hard-fought litigation, the Blue Cross and Blue Shield Association, together with its 36 Blue Cross/Blue Shield members (“the Blues”), recently announced a proposed settlement of class action antitrust...more