Pomerantz Haudek Grossman & Gross LLP announced that it and co-counsel Buttaci & Leardi, LLC filed a class action lawsuit against the Blue Cross Blue Shield Association and 22 leading BCBS insurers across the country on behalf of a putative nationwide class of health care providers, as well as the Pennsylvania Chiropractic Association ('PCA'), the New York Chiropractic Council, and the Association of New Jersey Chiropractors ('ANJC'). The suit challenges the Defendants' abusive practices in using post-payment audits and reviews, and improper repayment demands, to pressure providers to repay substantial sums that have previously properly been paid as health insurance benefits for services provided to BCBS subscribers. The action alleges that the post-payment audit and review process as applied by the various named BCBS Entities violates the Employee Retirement Income Security Act of 1974, in that its repayment demands are retroactive determinations that particular services are not covered under the terms of the BCBS health care plans, but without proper appeal or other protections otherwise available under ERISA for both self-funded and fully insured health care plans offered through private employers. The complaint further alleges that the post-payment audit and review process, as well as the forced withholds of unrelated benefit payments to offset alleged prior overpayments, violate the Racketeer Influenced and Corrupt Organizations Act ('RICO'). In the complaint, Plaintiffs allege that, as a means to maximize its profits, the BCBS Entities use their post-payment audit and review process to make retroactive adverse benefit determinations whereby they demand that providers repay funds they had previously received for providing services to BCBS subscribers. The Complaint further alleges that the BCBSA is coordinating the recoupment efforts with its state BCBS licensees on a nationwide basis. Plaintiffs seek to enjoin the BCBS Entities from continuing to engage in impermissible audit and recovery practices and to compel them to return the funds they have improperly withheld.

The Blue Cross Blue Shield Association (BCBSA) has announced that it has decided to sell Blue Healthcare Bank, which was organized in 2006 to sell health savings accounts to Blue Cross and/or Blue Shield members in qualifying health plans. The bank received its federal charter in 2007. BCBSA said that it is selling the bank, though the bank denies that it has lost interest in consumer-directed healthcare. Consultants note that the bank may simply be responding to the economy, which has made it hard for financial organizations to attract depositors and has been expensive to maintain.

Triple-S Management Corporation announced the Blue Cross Blue Shield Association has licensed the Blue Cross brand in Puerto Rico and the Blue Cross Blue Shield brands in the U.S. Virgin Islands to Triple-S Management Corporation and Triple-S Salud Inc.