According to reports, the passage of two bills within Michigan’s legislature – which will allow Blue Cross and Blue Shield of Michigan to convert itself into a nonprofit health insurer – could potentially negate some allegations currently standing against BCBS brought by the Department of Justice and Aetna Inc. claiming that the insurance company abused its dominance. Senate Bills 1293 and 1294 include a provision that would require BCBS of Michigan to stop enforcing “most favored nation” clauses in hospital contracts; In 2010 the DOJ brought charges against the health insurer claiming it forced 22 Michigan hospitals into “most favored nation-plus” contracts, which force the hospitals to charge higher prices to competing health insurers. The new legislation would also require Blue Cross to contribute a “fair share” of reimbursement to hospitals “to account for underfunded government programs and uncompensated care.” The new legislation could potentially mean some legal leniency in the insurer’s current antitrust cases with the DOJ and Aetna Inc., as the DOJ is only asking that Blue Cross stop using most-favored-nation clauses in contracts, a request that would be taken care of by new law.
Full Content: Crain’s Detroit Business
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