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Health care providers suing Blue Cross/Blue Shield for antitrust violations obtain ruling that strengthens their case

Health care providers suing Blue Cross/Blue Shield for antitrust violations obtain ruling that strengthens their case

Whatley Kallas convinces judge that more favorable standard should be used for much of the case

In an important ruling, Federal District Court Judge David Proctor decided that Blue Cross/Blue Shield must be judged by a less stringent standard from 2008 to the beginning of the COVID-19 pandemic in an antitrust case filed by health care providers.

“We are very pleased that the Court denied the Blues’ request to apply the ‘rule of reason’ standard to the providers’ very substantial ‘per se‘ past damages,” said co-lead counsel for the health care provider plaintiffs, Edith Kallas of Whatley Kallas. “Our provider plaintiffs have always been prepared to litigate this case, under both the ‘rule of reason‘ standard and the ’per se’ standard for historical damages, as provided in today’s order. We look forward to continuing to represent the interests of health care providers throughout the country in remedying the Blues’ continuing anticompetitive conduct.”

Under the “per se” rule, Blue Cross/Blue Shield will be required to provide evidence that it has not engaged in anticompetitive conduct. Under the “rule of reason” standard, the health care providers must show evidence that the insurance giant violated antitrust standards.

The judge’s ruling applies specifically to Section 1 Market Allocation Conspiracy claims, which relate to when a company – Blue Cross/Blue Shield in this case – causes one particular company to be the only one providing a good or service in specific areas. The “rule of reason” standard will be used for the portion of the claim after April 2021, when Blue Cross/Blue Shield reached a $2.67 billion settlement with subscribers.

In a separate ruling, the Court could not find that the health care providers’ Blue Card “group boycott” claims were appropriate for “per se” treatment.

About Whatley Kallas

The lawyers of Whatley Kallas, LLP have been repeatedly recognized in legal publications, by their peers and by leaders of organized medicine for their work in the health care field. More information is available www.whatleykallas.com.

General Contact:
Joe R. Whatley, Jr. and Edith Kallas
Whatley Kallas LLP: (800) 745-8153

Media Contact:
William Bray
WilliamB@Camginc.com
800-600-CAMG ext. 3324

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