Mount Nittany Health brought federal legal action alleging that the Blue Cross Blue Shield Association and its affiliated insurers have embarked on a long-standing collusion to remove the competition and underpass of health care providers, violating antitrust laws. Legal action, submitted Thursday before the US Pennsylvania intermediate district court, places the state -based health system among many health care providers contesting the practices of the country’s greatest health insurers.
According to the trialBlue Cross Blue Shield insurers would have divided exclusive geographic regions between them, preventing competition and use restrictive agreements to maintain low artificially low reimbursement rates for health care providers. According to the trial, these practices have led to payments significantly inferior to the providers they have received on a truly competitive market.
The legal file comes following a national regulation of collective appeal linked to similar allegations in an Alabama case, where Blue Cross Blue Shield agreed with a regulation of $ 2.8 billion without admitting a reprehensible act. The regulations should be finalized in July, and Mount Nittany Health is among the suppliers who withdrew, rather choosing to continue his complaints independently. The trial specifically appoints Highmark, capital and independence as defendants while listing several Blue Cross Blue Shield licensees as co-conspirators.
In relation: Lawyers are looking for a major payment in the antitrust case of the blue cross
According to a declaration included in the trial, agreements that prevent insurers from registering customers or negotiating supplier prices outside their designated territories effectively limit market expansion. The trial claims that if these insurers, which operate independently but are linked by their Blue Cross affiliation, were to establish supplier networks in new areas, increased competition would increase the reimbursement rates of health care providers.
The trial also argues that Blue Cross Blue Shield insurers take advantage of their combined market power and their generalized name recognition to remove payment rates below what would be expected in a competitive market. Health care providers, according to the trial, have little negotiation power and are likely to lose all Blue Cross Blue Shield patients if they refuse to comply with the restrictive agreements.
According to the complaint, these anti -competitive actions allowed insurers to pay for network suppliers at rates significantly lower than fair market value. Mount Nittany Health is looking for the triple of the amount of unpertified damage, as well as interest, lawyer fees and an injunction with the exception of Blue Cross Blue Shield insurers to continue the alleged practices to violate antitrust laws.
Source: State college