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2 Feb 2015, 6:16 pm
Blue Cross Blue Shield of Florida, Inc. 19 F.3d 562 (11th Cir. 1994), and stated that it does not require that the public disclosure contain an allegation of wrongdoing. [read post]
23 Mar 2017, 10:03 am
Blue Cross Blue Shield, which addressed whether health care providers had standing under ERISA to sue health plans for payment for services rendered to plan participants, given that the providers are not one of the categories of individuals – participants, beneficiaries and fiduciaries – expressly granted the power to assert benefit, breach of fiduciary duty or equitable relief claims under ERISA. [read post]
2 Dec 2013, 6:58 am
HNS negotiates with Payors (insurance companies like Blue Cross/Blue Shield and other third party purchasers of chiropractic services) to establish reimbursement rates for its members. [read post]
1 May 2013, 11:59 am
Still, given that, for example, Wellpoint, the corporate parent of Anthem Blue Cross Blue Shield and others, made a profit last year of more than $2.6 billion, how much farther will insurers go to fix a system that, for them, isn’t broken? [read post]
4 May 2017, 5:00 am
., 2017 NY Slip Op 03416, Appellate Division, Fourth DepartmentThe collective bargaining agreement between the West Seneca Central School District [District] and the employee organization representing certain employees provided that upon retirement employees in the collective bargaining unit "could enroll in the same Blue Cross/Blue Shield health insurance and Guardian dental insurance plans available to the District's then current employees, at their… [read post]
20 Mar 2013, 6:09 am
Another major breach involved WellPoint, the largest managed health care company in the Blue Cross and Blue Shield Association. [read post]
4 May 2017, 5:00 am
., 2017 NY Slip Op 03416, Appellate Division, Fourth DepartmentThe collective bargaining agreement between the West Seneca Central School District [District] and the employee organization representing certain employees provided that upon retirement employees in the collective bargaining unit "could enroll in the same Blue Cross/Blue Shield health insurance and Guardian dental insurance plans available to the District's then current employees, at their… [read post]
18 Feb 2015, 4:55 am
Effectively eliminate managed care networks.If regulators required them to fully cover charges by out-of-network doctors, that could reduce “incentives for providers to participate in networks” and make it harder to have adequate networks, America’s Health Insurance Plans, the insurers’ trade group, and the Blue Cross Blue Shield Association wrote in a joint letter to the NAIC.It would also raise premiums.Instead, AHIP says, states could… [read post]
27 Jun 2012, 11:36 am
Blue Cross & Blue Shield Ass'n, 161 F.3d 472, 478 (7th Cir. 2998)). [read post]
25 Apr 2012, 11:56 am
Blue Cross & Blue Shield Ass'n, 873 F.2d 1043, 1048 (7th Cir. 1989); cf. [read post]
26 Jul 2023, 1:45 pm
Blue Cross Blue Shield of Michigan (Tribal Contract Health; Discovery) State Courts Bulletin https://www.narf.org/nill/bulletins/state/2023.html In re Delila D. [read post]
10 Sep 2018, 5:26 am
Federal law governs most of th ose health plans — and it does not include such protections.About 60 percent of people with employer health benefits are covered by self-insured plans, but many don’t even know it, since employers typically hire an insurer to administer the plan and employees carry a card bearing the name of Blue Cross Blue Shield or another major insurer.States have the right to regulate INSURED products issued within… [read post]
13 Dec 2013, 12:10 am
The article notes that D&O insurers will be closely monitoring developments in the consolidated Blue Cross Blue Shield antitrust litigation pending before Judge David Proctor bin the Northern District of Alabama (about which refer here). [read post]
22 Nov 2011, 11:58 pm
Blue Cross Blue Shield of Texas, 2011 WL 4345845, at *5 (N.D. [read post]
5 Jan 2021, 6:33 pm
In Beverly Oaks, the U.S. 9th Circuit Appeals Court allowed an out-of-network healthcare provider to assert equitable claims under ERISA seeking a direct recovery of unpaid claims from Blue Cross and Blue Shield of Illinois (BCBS). [read post]
17 Nov 2023, 6:41 am
In re Blue Cross Blue Shield Antitrust Litig. [read post]
30 Jul 2011, 9:00 am
In Denise Hodges V Prudential Insurance Company of America & Horizon Blue Cross Blue Shield of New Jersey (Horizon), the plaintiff Denise Hodges alleged that Prudential had contravened the provisions of the Employee Retirement Income Security Act of 1974 (ERISA) by failing to pay disability benefits to her. [read post]
14 Sep 2022, 8:28 am
The untenable increases should have been mitigated by an offset of pandemic monies received by the State coupled with more effective negotiations with insurers and enforcement of contracts that require Horizon Blue Cross Blue Shield to provide more transparency on provider costs and quality. [read post]
4 Jan 2012, 9:44 am
Tufts Medical Center - Blue Cross Blue Shield of Massachusetts. [read post]
13 Sep 2011, 2:42 pm
This point is reflected in the ongoing litigation against Blue Cross Blue Shield of Michigan and American Express.International Cooperation, CoordinationThe acting antitrust chief said that she worked closely with her predecessor, Christine Varney, setting antitrust priorities. [read post]
