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Blue Cross Blue Shield Provider Settlement Opportunity

Client Alert

In re: Blue Cross Blue Shield Antitrust Litigation, MDL 2406, N.D. Ala., Master File No. 2:13-cv-20000-RDP is pending in the United States District Court for the Northern District of Alabama, and both parties have agreed, as of October 4, 2024, to a Settlement. If approved by the court, the Settlement will establish a $2.8 billion Settlement Fund. To participate in the Settlement, you must be a provider who meets the eligibility criteria described below and must submit the claim by July 29, 2025, online or by mail.

According to the BCBS Provider Settlement Website (BCBS PSW) there are two types of claims that can be filed: a professional claim and a facilities claim. Medical Professionals, Medical Groups, and Medical Organizations , which include any association, partnership, corporation or other form of organization that arranges for care to be provided to Blue Plan Members by Medical Professionals organized under multiple taxpayer identification numbers, should utilize the professional claim. Health Care Facilities, including any facility in which health care services are or were delivered to Blue Plan Members, and Health Care Systems (defined as any association, partnership, corporation or any other organization that arranges for care to be provided to Blue Plan Members by two or more Health Care Facilities organized under multiple taxpayer identification numbers), should utilize the facilities claim. Note that if a Medical Group is submitting a professional claim, the medical professionals who work for the Group must authorize the Group to submit a claim on their behalf, and the medical professionals cannot then also submit Claim Forms on their own behalf.

To be eligible to receive portions of the settlement, you must be a provider who currently provides or did provide healthcare services, equipment or supplies to any patient who was insured by, or was a Member of or a beneficiary of, any plan administered by any Individual Blue Plan during the Settlement Class Period of  July 24, 2008 to October 4, 2024. Providers constitute any person or entity that provides healthcare services in the U.S.

Providers who are excluded from the class and ineligible for the settlement include:

  1. Providers owned or employed by BCBS;
  2. Providers owned or employed exclusively by Government Entities, or Providers that exclusively provided services, equipment or supplies to members of or participants in Medicare, Medicaid, or the Federal Employee Health Benefits Programs;
  3. Providers that have otherwise fully released their Released Claims against BCBS prior to the Execution Date, including but not limited to Providers that were members of any of the settlement classes in Love v. Blue Cross and Blue Shield Association; and
  4. Providers that exclusively provide or provided: (a) prescription drugs; (b) durable medical equipment; (c) medical devices; (d) supplies or services provided in an independent clinical laboratory; or (e) services, equipment or supplies covered by standalone dental or vision insurance.

A claim for payment can be submitted online or by mail. Class members who submit a valid approved claim become Authorized Claimants. Ninety-two percent of the Settlement Fund will be allocated to Health Care Facilities and Health Systems, and eight percent will be allocated to Health Care Professionals.

For More Information, please contact BMD Healthcare Members Daphne Kackloudis at dlkackloudis@bmdllc.com or Amanda Waesch or alwaesch@bmdllc.com.


RNs and APRNs Take Note: Ohio Board of Nursing Mandates a New CE Reporting Period

Ohio’s Board of Nursing has updated the continuing education reporting period for RNs and APRNs. Beginning March 26, 2026, CE credits must be completed between July 1 and June 30 of odd-numbered years, replacing the previous November to October timeframe.

Ohio Med Spas: Peptide Do's and Do Not's

Recent guidance from the Ohio Board of Pharmacy outlines key compliance requirements for med spas using peptides. While some peptide drugs are FDA approved, others are not or cannot be compounded. Med spa operators should ensure they source medications from licensed suppliers, avoid non-approved or “research use only” products, and follow all compounding and storage regulations to maintain compliance and avoid enforcement actions.

Substance Use Disorder Providers: 42 CFR Part 2 Now Enforceable

Updates to 42 CFR Part 2 are now enforceable, bringing significant changes to how substance use disorder (SUD) records are handled. The Final Rule aligns Part 2 more closely with HIPAA, introduces updated penalties, allows a single patient consent for treatment, payment, and operations, and adds new requirements for Notices of Privacy Practices. It also creates a formal definition of SUD counseling notes and imposes strict consent requirements for their use and disclosure. Providers should review and update policies to ensure compliance.

AAA Introduces AI-Assisted Arbitrator for Certain Disputes

The American Arbitration Association has introduced an AI-assisted arbitration platform designed to streamline certain document-based disputes. While a human arbitrator still makes the final decision, the technology can improve efficiency, reduce costs, and accelerate case resolution. Companies should weigh these benefits against considerations such as transparency, risk, and contractual requirements before adopting AI-assisted arbitration.

Quiet Hours Texts and TCPA Claims: Consent Remains King as Courts Divide on Text Messages

Businesses face increasing TCPA lawsuits over off-hours marketing texts, but recent court decisions highlight strong defenses. Clear consumer consent and updated terms and conditions can defeat many claims, while a growing number of courts are finding that text messages are not “telephone calls” under the statute. Proactive compliance measures, including clickwrap agreements and forum-selection clauses, are critical to reducing risk.