Blue Cross Blue Shield health plans in seven states are under federal investigation to examine whether they are raising health-insurance premiums through agreements with hospitals that stifle business with rival payors, according to a Wall Street Journal report.
BCBS plans in Missouri, Ohio, Kansas, West Virginia, North Carolina, South Carolina and the District of Columbia have been issued civil subpoenas from federal investigators and some state attorneys general.
The anticompetitive clauses under investigation can simply be promises for the best pricing available, but they can violate antitrust laws if used improperly to inhibit business with competitors. Last fall, the Justice Department filed a suit against BCBS of Michigan, claiming it inhibited rivals through anticompetitive agreements with hospitals that allegedly raised healthcare costs and insurance premiums.
Read the WSJ report on Blue Cross Blue Shield.
Read more about BCBS.
– Financially Troubled Rhode Island Hospital Sues BCBS For Underpayments
– CaroMont Health and Blue Cross Create Bundled Payment Program for Knee Replacements
– Blue Cross Board Members’ Pay Suspension Will Not Fix Rising Healthcare Costs
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
