Who’s gonna pay for this? – Joe Sixpack
BCBS $2.8B antitrust settlement approved by federal judge
For employers, the agreement could mean that coverage from the Blues will be cheaper but more complicated.
By Allison Bell| August 22, 2025
A federal judge has given final approval to a $2.8 billion settlement between health care providers and Blue Cross and Blue Shield carriers over allegations that the Blues worked together to hold down payments to the providers.
U.S. District Judge R. David Proctor also called for the Blues to make efforts to increase market competition, and he allowed for about $657 million in attorneys’ fees and $102 million in attorneys’ costs and according to an order posted earlier this week.
The Blues agreed on the $2.8 billion payment figure in October 2024 and have denied any wrongdoing.
Representatives for the Blue Cross Blue Shield Association and its members said in a statement that the Blues are pleased with the settlement.
Representatives for the providers have called the settlement an “outstanding result.”
What it means for employers: The settlement agreement calls for the Blues to make changes in their BlueCard program.
The program helps employers that use the Blues for fully insured group coverage or administration of self-insured plans to offer access to a national network of health care providers who have agreed to accept the prices negotiated by Blue Cross and Blue Shield plans for care and to accept other contract terms, such as credentialing and quality terms, negotiated by the Blues.
One question is how the new settlement provider agreement will affect the employers and employer plan participants now using the BlueCard program to get access to a national provider network.
In theory, the agreement could make BlueCard provider access and pricing more complicated.
The Blues: The Blue Cross Blue Shield Association represents 33 separate health coverage providers.
Most were founded by the physicians or hospitals in their home states.
Today, some are nonprofit organizations, some are for-profit organizations that are owned by their members, and one, Elevance, is a large, for-profit company with stock that trades on the New York Stock Exchange.
The Blues provide or administer health coverage for 118 million people and have relationships with about 2 million health care providers, according to the Blue Cross and Blue Shield Association.
The association can influence the actions of its members by determining which entities have the right to use the Blue Cross and Blue Shield names and trademarks.
The antitrust litigation: Plaintiffs began suing association member companies over antitrust concerns in 2012.
The courts put the federal cases in a “multidistrict litigation” proceeding based in the Northern District of Alabama in 2013.
The Alabama court divided the cases into two main tracks: a track for subscribers, which included employers with fully insured plans and employers with self-insured plans, and a track for health care providers, including health care facilities and health care professionals.
Employers that participated in the antitrust litigation were part of another class of plaintiffs, for “subscriber plaintiffs.”
Proctor gave a $2.7 billion settlement for the subscriber plaintiffs preliminary approval in 2020 and gave the settlement final approval in 2022.
Related: Hospitals reject $2.8B BCBS settlement, claiming anticompetitive practices persist
The provider class has about 3.3 million members, according to the opinion discussing the final settlement approval order.
About 6,400 providers have opted out of the provider settlement. Supporters of the settlement agreement have noted that the number of providers opting out is small when compared with the size of the provider class, but the list of providers opting out includes large, prominent health care systems such as the Mayo Clinic and AdventHealth.
SOURCE: BCBS $2.8B antitrust settlement approved by federal judge
