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April 1, 2025

Philadelphia Health Systems Launch Antitrust Lawsuit Against BCBS

The Daily Pennsylvanian
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Contributed by: Kate Gamble
Summary
The University of Pennsylvania Health System (UPHS) and eight other nonprofit health systems in Philadelphia have filed an antitrust lawsuit against the Blue Cross Blue Shield Association in the District Court for the Eastern District of Pennsylvania. The plaintiffs allege that Blue Cross Blue Shield and its affiliates have manipulated market conditions to impose lower reimbursement rates on hospitals and physicians, which has contributed to rising insurance costs for consumers and stifled competition in the region, particularly benefiting Independence Blue Cross (IBX). This case reflects a national trend of healthcare providers alleging underpayment by insurance companies, and it specifically addresses concerns over potential price-fixing related to the Blue Card program, which standardizes payment rates for providers. The plaintiffs chose this legal action over a federal class action settlement, aiming for higher compensation for their claims.

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