Federal Investigation to Examine Whether Blue Cross Blue Shield's Pricing is Anti-Competitive

Blue Cross Blue Shield health plans in seven states are under federal investigation to examine whether they are raising health-insurance premiums through agreements with hospitals that stifle business with rival payors, according to a Wall Street Journal report.

BCBS plans in Missouri, Ohio, Kansas, West Virginia, North Carolina, South Carolina and the District of Columbia have been issued civil subpoenas from federal investigators and some state attorneys general.

The anticompetitive clauses under investigation can simply be promises for the best pricing available, but they can violate antitrust laws if used improperly to inhibit business with competitors. Last fall, the Justice Department filed a suit against BCBS of Michigan, claiming it inhibited rivals through anticompetitive agreements with hospitals that allegedly raised healthcare costs and insurance premiums.

Read the WSJ report on Blue Cross Blue Shield.

Read other coverage about Blue Cross Blue Shield:

- Health Insurers' Coverage Decisions Vary Widely, Often Reversed, GAO Says

-
Illinois Blue Cross Blue Shield Will Pay $25M to Settle Allegations of Denying Children Coverage, Shifting Costs to Medicaid

-
BCBS-NC Makes Some Changes to Spinal Fusion Policy

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