Blue Cross

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Manatt on Health Reform: Weekly Highlights - September 2015 #5

New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more

Excellus Blue Cross Blue Shield sued for data breach announced last week

Within days of Excellus Blue Cross Blue Shields’ (Excellus) announcement that its data had been accessed by a hacker through a “sophisticated” cyber-attack, two law firms teamed up to file a proposed class action suit last...more

10 Million Affected by Sophisticated Cyberattack

The latest major health insurance data breach of 2015 reported by Excellus BlueCross BlueShield is considered one of the top 20 worst reported breaches of a healthcare organization. The attack affected about 7 million...more

Blog: Excellus is Latest in Line of BCBS Insurers Experiencing Cyberattack

Excellus, a BlueCross BlueShield (BCBS) provider servicing upstate New York, announced last week that it was the latest in a string of BCBS providers that experienced a data breach as a result of a cyberattack. CareFirst...more

IREG Update - September 2015 #2

Hot Topic: Auto insurance in the age of the driverless car - Background - Not surprisingly, the most common cause of vehicle accidents is human error. Whether a motor vehicle offers one automated function or fully...more

Exellus BlueCross BlueShield – Latest Victim of a “Sophisticated” Health Plan Cyberattack

Exellus BlueCross BlueShield has announced that the personal information of at least 10 million members has been compromised in a “very sophisticated” cyberattack that occurred on December 23, 2013 and was discovered by the...more

10 million Excellus Blue Cross Blue Shield members’ information compromised

Yesterday, Excellus Blue Cross Blue Shield, located in Rochester, NY, announced that it will notify up to 10 million members that it was the victim of a cyber-attack dating back to December of 2013 that exposed their members’...more

Manatt on Health Reform: Weekly Highlights - September 2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

Blue Cross of Northeastern Pennsylvania Denied Peer Review Protection

The Pennsylvania Superior Court has decided the Pennsylvania Peer Review Protection Act does not apply to alleged peer review activity conducted by Blue Cross of Northeastern Pennsylvania, because Blue Cross is not a...more

CareFirst BlueCross BlueShield sued for hacking incident

Not to be left out, plaintiffs filed suit against CareFirst BlueCross Blue Shield late last week for the hacking incident the insurer suffered in May, which resulted in unknown intruders gaining access to names, dates of...more

Changes to the Terms of BCBSM’s Administrative Services Contracts in the Wake of Hidden Fees Suits

Effective January 1, 2016, Blue Cross Blue Shield of Michigan ("BCBSM") will implement significant changes to the Administrative Services Contracts ("ASCs") issued to its self-funded customers. Notably, BCBSM has attempted to...more

Chasing Payments: District Court Holds that Providers Lack Standing to Sue ERISA Plans for Benefits if the Patients Remain Liable...

A district court in Tennessee recently rejected ERISA claims by healthcare providers against a plan insurer, holding that the providers lacked standing to sue under ERISA as their patients’ assignees. Brown v. Blue Cross...more

Investors Should Be Aware of an Interesting Blue Cross Antitrust Case

It was recently reported that Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs. One plaintiff class reflects...more

Insurer Escapes Antitrust Suit, But Hospital Must Continue the Fight

A large regional health insurer extricated itself from an antitrust suit, leaving the dominant local hospital to square off alone versus an ambulatory surgical center (ASC). The U.S. District Court for the Southern District...more

CareFirst, Third Major Health Insurer This Year To Be Hit By Cyberattack

On May 20, 2015, CareFirst BlueCross BlueShield (“CareFirst”) announced that it was the latest victim of a major cyberattack, with as many as 1.1 million plan customers affected. Current and former CareFirst members and...more

Blog: CareFirst Discloses Data Breach

CareFirst, a Blue Cross Blue Shield plan serving the Washington D.C. metro area, became another in a line of health insurers to suffer a data breach as a result of hackers. CareFirst and the FBI are examining the breach...more

Businesses May Have Until At Least 2017 To Recover Hidden Access Fees Taken By Blue Cross Blue Shield

Great news for the hundreds of businesses from which Blue Cross Blue Shield of Michigan charged hidden fees: a federal court's recent ruling indicates that the businesses have several more years to file claims against BCBSM...more

CareFirst Suffers Cyberattack, Data Breach of 1.1 Million Customers’ Information

BREAKING NEWS: Health insurer CareFirst BlueCross BlueShield disclosed today that hackers gained access to one of its databases, exposing personally identifiable information for approximately 1.1 million people....more

ERISA (3rd Circuit): Even a Voluntary Settlement Can Mean “Some Success on the Merits” When Awarding Attorney Fees?

You know that a court has discretion to award attorney fees under ERISA if a party shows “some degree of success on the merits.” But how do you define “success”? A new third circuit case reminds one of that old Milton...more

Federal Court Rejects BCBSM’s “Schedule A” Argument

In a recent decision in one of the many cases against Blue Cross Blue Shield of Michigan seeking return of hidden administrative fees, a federal court rejected one of BCBSM's primary arguments. BCBSM has consistently argued...more

Federal Judge Rules BCBSM’s “Value of Blue” Report Did Not Disclose Hidden Fees

A federal judge in the case of Alma Products v. BCBSM recently agreed with arguments presented by Varnum that Blue Cross Blue Shield of Michigan's "Value of Blue" report did not reveal that it was charging hidden fees (often...more

Employee Benefits Developments - April 2015

Health Insurance Company’s HIPAA Breach Affects Millions. At the end of January, a national BlueCross BlueShield affiliate, Anthem, Inc., discovered that its information technology systems were hacked. The information...more

Anthem Data Breach Requires Plan Sponsor Attention

On January 29, 2015, Anthem Inc., one of the largest managed health care companies in the country, disclosed that the sensitive personal data of almost 80 million current and former participants in its network was breached in...more

Insurer’s Agreements with Providers Are Not Per Se Antitrust Violations

The Iowa Supreme Court refused to categorize a health insurer’s agreements with providers in Iowa and its participation in the national Blue Cross and Blue Shield (BCBS) network as per se violations of the antitrust laws. ...more

New Venture Seeks to Support Independent Physicians in Texas

The Texas Medical Association (TMA) and Blue Cross Blue Shield of Texas are launching a new services company, TMA PracticeEdge, to facilitate bringing the benefits of value-based reimbursements to the state’s independent...more

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