MCAG is assisting eligible health care providers, including medical professionals, medical groups/organizations, and healthcare facilities/health systems in submitting claims for their share of the $2.8 billion Blue Cross Blue Shield Provider Settlement. This class action antitrust settlement is now open for claim submissions, and providers must act before the deadline on July 29, 2025 to participate. Here is a list of the common questions asked about this settlement.
Q: Who is Eligible?
A: Health care providers and facilities in the U.S. that provided health care services, equipment, or supplies between July 24, 2008, and October 4, 2024 to patients insured by Blue Cross Blue Shield (BCBS) plans may qualify.
Exclusions:
You are NOT eligible if you are:
A physician licensed before March 12, 2008 who did not opt out of the Love v. Blue Cross Blue Shield Association settlement.
Owned or employed by a Blue Cross Blue Shield entity.
Exclusively providing services for Medicare, Medicaid, or Federal Employee Health Benefits Programs.
A provider limited to prescription drugs, durable medical equipment, medical devices, independent clinical lab services, or standalone dental/vision services.
Q: What If I’m a Physician Licensed Before March 12, 2008?
A: Physicians licensed before March 12, 2008 are generally excluded unless they opted out of the Love settlement. Since there is no mechanism to verify opt-outs from that case, such physicians should assume they cannot file a claim. However, their medical groups, employees, and independent contractors may still be eligible to file.
Q: Does the Settlement Apply to Non-Physician Providers?
A: Yes! This includes:
Advanced practice providers
Nurses
Mental health professionals
Medical groups and facilities (e.g., hospitals, health systems)
Q: How Do I Submit a Claim?
A: Eligible providers can submit claims via the BCBS Provider Settlement website or have a claim filed on their behalf to receive funds from the settlement. Online filing is recommended.
Hospitals/health care facilities or health systems would submit a Facilities Claim Form and there are two options to submit this type of claim:
Default: No action required; defendants’ data and extrapolations will be used to calculate your estimated allowed amounts for the settlement period.
OR
Alternative: Supply either all or partial estimated Allowed Amounts (by year and inpatient/outpatient).
Partial data can be submitted under the Alternative Method, and estimates will be forecasted for missing years.
Individual medical professionals or medical groups/organizations should submit a Professional Claim Form choosing a Range of Allowed Amounts covering the Settlement period.
No supporting documents are required at the time of filing, but the Settlement Administrator may request additional documentation later.
Q: How Will Payments Be Determined?
A: Payments are partially based on Allowed Amounts for services covered under Blue commercial plans between July 24, 2008, and October 24, 2024. Government plans (e.g., Medicare Advantage) are excluded. Allowed Amounts will be multiplied against a Harm Coefficient, created from a regression model that calculates the impact of Defendants’ actions on different Providers.
Q: What Happens If I Don’t Submit a Claim?
A: Providers who do not file will not receive any monetary settlement but will still benefit from required changes to BCBS business operations, including modifications to the BlueCard Program.
Q: What If I Want to Opt Out?
A: Opting out preserves your right to sue the BCBS defendants separately. The deadline to opt out is March 4, 2025. Instructions for opting out are available on the BCBS Settlement website (FAQ 19).
Key Deadlines
Claim Submission Deadline: July 29, 2025
Opt-Out Deadline: March 4, 2025
Q: Where Can I Learn More?
A: Visit the BCBS Settlement website for detailed FAQs and guidance from the Settlement Administrator: https://www.bcbsprovidersettlement.com/Home/FAQs
For assistance with claim submissions, contact MCAG today!
Q: Why Should We Choose MCAG to File Our Claim?
Navigating the complexities of class action settlements can be time-consuming and overwhelming. MCAG simplifies the process by handling your claim from start to finish, ensuring you maximize your potential payout.
Key Benefits of Using MCAG:
Expert Guidance: Our team specializes in class action settlements and ensures your claim is filed correctly and on time.
Maximized Recovery: We help you identify all eligible claim amounts so you don’t leave money on the table.
No Upfront Costs: MCAG only gets paid when you receive your settlement—there’s no risk to you.
Hassle-Free Process: We handle all the paperwork and administrative tasks, so you can focus on running your practice.
Don't miss out on your share of the $2.8 billion settlement—let MCAG file your claim for you! Contact us today to get started.
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