Jefferson Health is a part of class action suit against Blue Cross Blue Shield. Here’s why

Leif Greiss, The Morning CallMorning Call

Jefferson Health, parent company of Lehigh Valley Health Network, is part of a class action lawsuit against the Blue Cross Blue Shield and its affiliates that alleges the insurance giant conspired to violate antitrust laws and underpay health networks.

Jefferson joined the lawsuit filed in California by multiple health networks from across the country in March. The suit accuses Blue Cross Blue Shield of illegally dividing and allocating markets to its benefit and of price fixing.

St. Luke’s University Health Network also is suing Blue Cross Blue Shield as part of a separate federal lawsuit filed in Pennsylvania.

The plaintiffs in the lawsuit Jefferson is party to are seeking to be awarded damages in the form of three times the amount that they suffered due to Blue Cross Blue Shield’s alleged conduct. The suit does not provide an exact figure but estimates that the health networks were under-reimbursed by billions of dollars.

A spokesperson for Blue Cross Blue Shield said the association does not comment on active litigation.

In 2024, Blue Cross Blue Shield agreed to a $2.8 billion settlement as a part of a national class action suit originally filed in 2012 by hospitals and other health care providers, claiming they were underpaid. All parties currently suing the health insurance giant would qualify to collect from that settlement, but have eschewed it, potentially standing to gain more on an individual basis through the latest suit.

Blue Cross Blue Shield and all its affiliates and subsidiaries named in the suit provide health insurance coverage for more than 100 million Americans in all 50 states as well as the District of Columbia and Puerto Rico. The lawsuit states that Blue Cross has used its reach, power and large network of affiliates to create exclusive service areas to avoid competition between these affiliates and generate more revenue for itself.

The plaintiffs argue this has led to increased administrative costs, claim denials, underpayments and payment delays for health care networks. They also argue that Blue Cross’s actions have increased the cost of care to patients.