Medical providers, including individuals, physician groups, hospitals, surgery centers, health systems and other health care facilities, may be eligible for a portion of a $2.8 billion settlement reached by the Blue Cross Blue Shield Association and individual Blue plans to resolve a class action antitrust lawsuit (the “Settlement”).

The Settlement has received preliminary approval from the U.S. District Court for the Northern District of Alabama. Now, eligible providers and health care facilities have until July 29, 2025 to submit a claim to participate in the Settlement.

Who is eligible to participate?

All health care providers and facilities in the United States, unless excluded (see below), who provided health care services, equipment or supplies from July 24, 2008 to October 4, 2024 to any patient who was insured by Blue Cross Blue Shield of Alabama or other Blue plan defendants can participate in the Settlement.

Providers who are ineligible to participate in the Settlement include:

1. Physicians (MDs or DOs) who were licensed to practice medicine before March 12, 2008 and did not opt out of the settlement in Love v. Blue Cross and Blue Shield Association, No. 1:03-cv21296-FAM (S.D. Fla.);
2. Providers owned or employed by the settling defendants, including the Blue Cross Blue Shield Association or any of the individual Blue plans;
3. Providers owned or employed exclusively by government entities or which exclusively provide services, equipment or supplies to members of or participants in Medicare, Medicaid or the Federal Employee Health Benefits Programs; 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.

I am a physician who was licensed to practice medicine before March 12, 2008. Am I excluded from the Settlement?

Physicians who were licensed before March 12, 2008 likely received a notice regarding the Love settlement at the time of its administration providing information to either: (a) submit a claim; or (b) opt out. Most people do not opt out of class action settlements. When they do, it is usually to preserve a right to sue the defendants in the future. Absent actual knowledge or evidence that a physician licensed before March 12, 2008 opted out of the Love settlement, the physician is likely excluded from the Settlement. Given the passage of time, we are not aware of any mechanism to confirm whether a physician did or did not opt out of the Love settlement.

While some physicians are excluded from the Settlement, their medical groups and other eligible providers of their medical groups, including employees and independent contractors, can submit a claim to participate in the Settlement.  A medical group can submit a claim on behalf of its eligible providers, as long as the eligible providers: (a) authorize the filing of a claim by the medical group on their behalf; and (b) do not also submit a claim on their own behalf.

I am an individual provider, but I am not a physician. Does the Settlement apply to me?

Yes, the Settlement broadly applies to any person or entity that provides health care services, including physicians, advanced practice providers, nurses and mental health professionals. It also includes medical groups and health care facilities, including hospitals and health care systems.

How do I submit a claim to participate?

Eligible providers can submit a claim by visiting the BCBS Settlement website. Eligible providers and medical groups should submit a claim using the Professional Claim form, and eligible health care facilities should submit a claim using the Facilities Claim form. Claim filings can be made online or by mailed paper filing, but online filing is highly recommended. The deadline to submit a claim is July 29, 2025.

Some organizations may need to submit both a Professional Claim form and a Facilities Claim form to capture both professional and facility fees. Examples include:

• A hospital making a claim for its facility and its medical professionals; or
• A radiology group making a claim for its providers and its imaging center.

Providers and facilities will have no obligation to submit supporting documentation with their claim filing. However, the Settlement Administrator may request supporting documentation following the review of submitted claims.

How is the Settlement payment determined?

Settlement payments are determined differently for medical professionals and health care facilities, but both are based on “Allowed Amounts” for covered services provided from July 24, 2008 to October 24, 2024. The Settlement applies only to Blue commercial plans. All government plans, including Medicare Advantage plans sponsored by a Blue plan, are excluded.

What if I am eligible, but I do not submit a claim?

In order to receive any monetary benefit from the Settlement, providers and facilities must timely submit a claim. The Settlement also requires Blue Cross Blue Shield to make certain changes to its business operations, including changes to the BlueCard Program. These non-monetary benefits will be available to all providers and facilities, including those who do not submit Settlement claims.

Non-submission of a claim form is not the same as opting out of the Settlement. If you want to opt out of the Settlement (for example, to preserve your right to individually sue the defendants), you must send an exclusion request to the Settlement Notice Administrator.  Information on the process for opting out can be found at the BCBS Settlement website FAQs (See FAQ 19).

What is the deadline to submit a claim or opt out of the Settlement?

The deadline to submit a claim is July 29, 2025. The deadline to opt out is March 4, 2025.

How do I learn more about the Settlement?

Visit the BCBS Settlement website, where the Settlement Notice Administrator has prepared a helpful Frequently Asked Questions page to assist providers and facilities with their claim filings.

Additionally, Co-Lead Counsel to the Settlement is hosting ongoing webinars for providers and facilities to learn more about the claims submission process. Upcoming webinar dates are available on the Settlement website linked above.