The FEHBlog wraps up a pleasant long weekend with family in Minneapolis tomorrow. Like the FEHBlog, Congress returns to Capitol Hill tomorrow following a two week long recess. Modern Healthcare reports that Congress is nearing the finish line on legislation to address the opioid crisis that goes beyond funding.
Health Payer Intelligence tells us about new payer approaches to incorporating preventive care and wellness initiatives into their holistic health programs intended to help people avoid or control chronic disease. Good luck with that worthy effort.
The Associated Press reports that last week a federal judge in Alabama issued a ruling in an antitrust case against the Blue Cross Blue Shield Association, The federal judge “agreed to let plaintiff lawyers move ahead with allegations that some actions by 36 [Blue Cross] state insurance operations could amount to an automatic violation of antitrust laws.” The Wall Street Journal adds that
The case has a long way to go. [The lawsuit was filed in January 2013.] The judge left open at least one potential defense for the insurers’ actions, and the lawsuits against the Blue insurers haven’t yet been certified to proceed as class actions, an issue that could take several more months to resolve.
The AP story notes that “An attorney for the Blue Cross Blue Shield Association, Scott Nehs [actually the Association’s general counsel], says the organization will appeal.” Furthermore, according to the Journal,
the new ruling also held some positive aspects for the insurers. The judge ruled that another aspect of the Blue companies’ cooperation, a program that involves working together to offer national insurance plans [e.g., the Blue Cross Federal Employees Plan] wasn’t an automatic antitrust violation. He also said it wasn’t yet clear whether the Blue insurers effectively operate as a single entity, which could shield their actions against the antitrust allegations.
It’s not easy being a health insurer.