It's never good for business when you've angered 900,000 doctors. But with any luck, that chapter is over for 23 Blue Cross and Blue Shield plans, which were targeted by a class-action lawsuit alleging unfair payment practices. The suit, which was filed in 2003, asserted that 23 BCBS plans were habitually cheating doctors by deliberately paying for less-intensive services than they had in fact provided. The BCBS plans have agreed to pay $128 million to settle the suit, and pay as much as $49 million in legal fees. (The deal doesn't extend to Blue Shield of California, which is still in talks with physicians.) Now execs at these BCBS plans can begin to rebuild their physician relationships; for example, they've agreed to adopt new, scientifically-based clinical guidelines to use for medical necessity determinations. Unfortunately for them, however, doctors' trust may take a bit longer to mend.
To find out more about the suit:
- read this article in the Los Angeles Times