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Another company in the Blue Cross and Blue Shield empire – Highmark Inc., and Highmark West Virginia, Inc., which does business as Mountain State Blue Cross and Blue Shield – has settled the national antiracketeering lawsuit against HMOs.
Claim forms [PDF] and instructions [PDF] have been mailed to physicians, who have until Feb. 27, 2008, to file a claim. The claims must be postmarked by that date and sent to the settlement administrator at Highmark/Mountain State, Settlement Administrator, PO Box 3775, Portland, OR 97208-3775. If you have not received the forms, you can click on the link above and print them.
You can file a claim for payment by Highmark even if you already sought reimbursement when Blue Cross and Blue Shield of Texas and other Blue Cross companies settled their portions of the lawsuit last spring. As well, physicians who did not file a claim then can submit one now.
You also have the option of donating your share of the settlement to the Texas Medical Association Foundation. The TMA Foundation is the philanthropic arm of TMA. Its purpose is to attract donations in support of TMA's ambitious health improvement initiatives such as Be Wise — ImmunizeSM and Hard Hats for Little Heads. The TMA Foundation also supports TMA county medical society and alliance and medical student chapter community health and education programs. Gifts to the TMA Foundation are tax-deductible to the full extent permitted by law.
You can opt out of the Highmark settlement, but you must send a written request to the settlement administrator at the address above by Jan. 14. Include your name, business address, telephone number, federal tax identification number, and signature.
Physician groups or physician organizations may exclude themselves, as distinct legal entities, from the settlement by submitting an opt-out request. Physician groups or physician organizations may not request to opt out individual physicians, unless the group or organization has written authorization to act on behalf of those physicians and the authorization has been submitted to the administrator.
More than 90 percent of Blue Cross and Blue Shield health plans and the Blue Cross and Blue Shield Association have agreed to implement key business practice changes and to restructure the way they administer and pay for medical care for Blue Cross enrollees. Click here for more details on the BCBS settlement.
All practicing Texas physicians can benefit from the settlement, receiving prospective relief from changes to Blue Cross practices, and, if they file a claim, retrospective relief from payments of previously unpaid claims.
TMA was involved in the case, including the settlement negotiations, since its filing, but not as a formal plaintiff. The Connecticut State Medical Association was the state medical society plaintiff, along with several physicians. TMA was a formal party with respect to several of the other defendants in the original class action suit against the other 10 major carriers and is a signatory to the Blue Cross and Blue Shield of Texas settlement.
Action, Jan. 1, 2008
Last Published: 1/2/2008 Print this page
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