PHYSICIANS WIN SETTLEMENT AGAINST
BLUE CROSS AND BLUE SHIELD OF FLORIDA
On April 27, the Blue Cross and Blue Shield Association
and 23 of its affiliated companies, including Blue
Cross and Blue Shield of Florida, filed a settlement
in the Federal District Court in Miami. This settlement
upon approval will establish 128 million dollar fund
which doctors may seek compensation or donate money
to a charity. The Blue plans also agreed to pay physicians’
legal fees, up to $49 million.
The settlement also calls for enhancements in business
practices including the way BCBSF processes and pays
claims. A number of improvements called for in the
settlement are already in place at BCBSF or are underway
as part of their focus on continuous improvement.
The settlement is the third legal settlement
between physician groups and large health insurers.
In 2003, Aetna U.S. Healthcare agreed to pay $170
million and Cigna Healthcare agreed to pay $540 million
to correct a pattern of unfair business practices.
United Health Care is the last health insurer who
has not settled in this case.
The class action - Love et al. v. Blue
Cross and Blue Shield Association, et al. - was filed
in 2003, and has been pending before U.S. District
Judge Federico Moreno in federal court for the Southern
District of Florida in Miami. The complaint identified
numerous Blue Cross and Blue Shield plans as defendants
in an alleged scheme to defraud doctors in violation
of the federal Racketeer Influenced and Corrupt Organizations
To view a copy of the agreement CLICK