Highmark pays $10M to settle physician class action

Pennsylvania Blue plan Highmark Inc. has agreed a $10 million settlement with a group of physicians that claimed it engaged in unfair business practices. The details of the settlement are similar to a $128 million settlement closed earlier this year between two dozen other BCBS plans and 900,000 physicians across the U.S.  It's likely that it settled, as much as anything, because it's facing intense scrutiny over its plans to merge with Independence Blue Cross, forming a mega-insurer which would dominate the state.

As in other cases, the physician-plaintiffs argued that the health plan engaged in RICO violations by systematically denying and delaying payments rightfully owned them, as well as under-paying claims. Total costs to Highmark could hit almost $14 million over time, as Highmark will also pay as much as $3.81 million of the doctors' legal fees and an additional $7,500 per class-action plaintiff.

To learn more about the settlement:
- read this Pittsburgh Post-Gazette piece

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