Judge: BCBS plans can appeal lawsuit claiming automatic antitrust violation

The Blue Cross Blue Shield Association can appeal claims that the way it does business may be an automatic violation of federal antitrust regulations, according to Law360.

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Here are three things to know about the case:

1. In an April 5 ruling, U.S. District Judge R. David Proctor said provider- and member-sponsored litigation claiming BCBSA and its 36 members worked together under competitive restrictions, when considered altogether, may be a “per se” violation of the Sherman Act. The Sherman Act is the federal law banning unlawful trade restraints.

2. In a June 12 order, Mr. Proctor OK’d BCBSA’s bid for an immediate appeal of the per se ruling, which would have barred the insurer from arguing collaboration among its plans is pro-competitive.

3. Mr. Proctor’s order certified BCBSA’s interlocutory appeal claiming there is ample room for disagreements over the judge’s previous decision to consider the per se standard. The per se standard also would have automatically assumed the associations engaged in price-fixing and other serious antitrust violations, according to Law360.

More articles on payer issues:
DOJ abandons most of lawsuit accusing UnitedHealth of Medicare fraud
UnitedHealth seeks damages from $1B+ Medicare lawsuit
Judge: DOJ’s suit accusing UnitedHealth of $1B Medicare fraud can proceed

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