Patient Rights Advocate Files Amicus Brief in Lawsuit Against Blue Cross Blue Shield of Minnesota

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The fight over affordable drug prices continues.

PatientRightsAdvocate.org announced that it has filed an amicus brief in the Department of Labor’s (DOL) case against Blue Cross Blue Shield of Minnesota.¹ Acting secretary of labor Julie A. Su filed the case in January of this year, claiming that Blue Cross collected about $66.8 million for provider taxes from 370 self-funded employer health plans.

Provider taxes vary from state to state, but they are typically paid by hospitals and clinics. These funds can be used as a source of funding for Medicaid, provided they meet certain requirements.

In the lawsuit,² the DOL of writes, “BCBSM, Inc. has for years unilaterally caused the self-funded health benefit plans for which it serves as third-party administrator to compensate BCBSM, Inc.’s in-network providers for amounts they owe under a Minnesota provider tax—amounts the providers never billed or passed on to the plans—without authority to do so under the plans’ governing documents.Between 2016 and 2020, BCBSM collected at least $66.8 million from the plans for the payment of its network providers’ obligations under Minnesota’s provider tax.By exercising discretionary authority over the plans in this way, BCBSM, Inc. acted as a fiduciary of the plans and violated ERISA’s fiduciary standards and prohibited transaction rules by serving its own interests over those of the plans.”

In its brief, PatientRightsAdvocate.org argues that Blue Cross’ actions obstructed plan beneficiaries from being able to find cost-efficient care.

In a press release, PatientRightsAdvocate.org founder and chairman Cynthia Fisher said, “PatientRightsAdvocate.org commends the Department of Labor for acting to protect patients and employers. We are pleased to support DOL in helping explain to the court why Blue Cross acted unlawfully and in breach of its duties by secretly charging employer health plans for provider taxes. We look forward to the court's resolution of this important case, and we will continue to fight on behalf of patients to make healthcare more affordable, transparent, and accountable."

This is the latest move made by the patient rights organization to ensure that patients have access to affordable healthcare.

In January of this year, PatientRightsAdvocate.org revealed the results of a poll conducted on healthcare costs.³ According to a press release issued at the time, the vast majority of respondents (94%) said that they support true healthcare price transparency. A similar number (93%) said they also believed that hospitals should be required to provide potential patients with actual prices ahead of time, as opposed to estimates.

Most importantly, three-out-of-five respondents said that they have put off medical care due to the cost.

In a press release issued at the time, PatientRightsAdvocate.org included a quote from a letter that it’s founder and chairman Cynthia Fisher sent to congressional leaders. In the letter, she wrote, “Congress has the rare and exciting opportunity to pass transformative, bipartisan healthcare price transparency legislation that would drastically improve the quality and lower the cost of American healthcare, at no cost to taxpayers. ...It is time to harness this momentum and bring both chambers together to move forward with bipartisan, bicameral legislation that levels the playing field, empowers healthcare consumers, lowers costs, improve health outcomes, and has the support of the American people. This is the right policy, at the right time, for the right reasons. It's time to fix our broken healthcare system through systemwide healthcare price transparency."

Sources

1. PatientRightsAdvocate.org files Amicus Brief in U.S. Department of Labor Case Against Blue Cross and Blue Shield of Minnesota. Patient Rights Advocate. April 26, 2024. https://www.prnewswire.com/news-releases/patientrightsadvocateorg-files-amicus-brief-in-us-department-of-labor-case-against-blue-cross-and-blue-shield-of-minnesota-302128711.html
2. JULIE A. SU, Acting Secretary of Labor, Plaintiff, v. BCBSM, INC., d/b/a Blue Cross and Blue Shield of Minnesota. Department of Labor. January 12, 2024. Accessed April 26, 2024. https://si-interactive.s3.amazonaws.com/prod/plansponsor-com/wp-content/uploads/2024/01/16160911/Su_V_BCBSM_January_2024.pdf
3. New Polling Reveals 94% of Americans Support Healthcare Price Transparency. Patient Rights Advocate. January 9, 2024. Accessed April 26, 2024. https://www.prnewswire.com/news-releases/new-polling-reveals-94-of-americans-support-healthcare-price-transparency-302030645.html