Blue Cross lawsuit overview:
- Who: The state of Michigan filed an antitrust lawsuit against Blue Cross Blue Shield of Michigan Mutual Insurance Co.
- Why: The state alleges Blue Cross violated antitrust laws by conspiring with other Blue Cross Blue Shield entities.
- Where: The Blue Cross lawsuit was filed in Michigan federal court.
AThe state of Michigan filed a lawsuit against Blue Cross Blue Shield of Michigan Mutual Insurance, alleging the insurer violated antitrust laws by conspiring with other Blue Cross Blue Shield entities to allocate customers and territories, restrict output and eliminate competition for health insurance services.
The Blue Cross lawsuit alleges the insurer’s illegal agreement prevented competition for the contract to administer state employees’ medical benefit plan, which has allowed Blue Cross Blue Shield Michigan to overcharge the state for administering the state employee plans for years.
The state claims the same conspiracy harmed the people of Michigan by depriving them of the choice and quality that a competitive market would provide and by forcing Michigan employers and consumers to pay inflated premiums and higher out-of-pocket costs.
Blue Cross paid providers below market rates, antitrust lawsuit claims
The Blue Cross lawsuit further alleges that the insurer abused its dominant market position to drive the rates it pays health care providers to some of the lowest in the nation, including, in some instances, rates well below the cost of providing necessary care.
“Unable to obtain appropriate market payments from Blue Cross, Michigan providers have been forced to reduce services, cut staff, close facilities or exit the Michigan market entirely, degrading the healthcare infrastructure upon which Michigan residents depend and leading to the state’s worsening health outcomes,” the Blue Cross lawsuit says.
The antitrust lawsuit asserts claims for violations of the Sherman Act and Michigan Antitrust Reform Act, public nuisance and unjust enrichment.
The state seeks actual and treble damages, civil penalties, restitution and disgorgement, declaratory and injunctive relief, an accounting of all fees, profits and other monies obtained by Blue Cross through its unlawful conduct, and payment of monies necessary to abate the public nuisance.
In related news, Blue Cross agreed to a $2.67 billion class action settlement in Alabama federal court to resolve long-standing claims it engaged in anticompetitive practices.
What do you think about the allegations made in this Blue Cross lawsuit? Join the discussion in the comments!
The plaintiffs are represented by Scott Mertens and Jonathan Comish of the Michigan Department of Attorney General; Matthew J. Platkin, Angela Cai and Aaron E. Haier of Platkin LLP; and Jon Corey and James H. Smith of McKool Smith P.C.
The Blue Cross antitrust lawsuit is Michigan, et al. v. Blue Cross Blue Shield of Michigan Mutual Insurance Company, Case No. 2:26-cv-13834, in the U.S. District Court for the Eastern District of Michigan.
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