Important information for psychologists regarding the Blue Cross Blue Shield settlement

Psychologists who treated patients insured by any Blue Cross Blue Shield company (collectively, BCBS) between July 24, 2008, and October 4, 2024, may be eligible for compensation from a significant antitrust litigation settlement. This article provides preliminary information about the BCBS settlement and the claims process, and to inform you that the deadline for submitting claims is July 29, 2025.

If you provided services during this time period, you should keep an eye out for mail or email from the Settlement Administrator, BrownGreer PLC, because it may contain important information regarding the settlement and your claims. That notice is also significant because it may be an indication that your claims to BCBS are included in the class action attorneys’ database, as mentioned below.

In the lawsuit, In re: Blue Cross Blue Shield Antitrust Litigation (MDL No. 2406opens in new window), it was alleged BCBS violated antitrust laws by limiting competition and fixing prices. To resolve this, BCBS agreed to a $2.8 billion settlement fund to avoid the risk and cost of further litigation. BCBS also agreed to some policy changes that we will address in later articles.

The settlement class includes all U.S. providers, who provided health care services, equipment, or supplies to BCBS members from July 24, 2008, to October 4, 2024. This includes most psychologists who treated BCBS patients during that period. There are some exceptions, like those employed exclusively by the government or those only providing certain services, which do not appear to include mental health services.

A $2.8 billion fund has been established to compensate claimants. Still, understanding how this money is allocated is important. Only 8% ($224 million) is allocated to Professionals, a category that includes medical and health care groups, medical organizations, and then individual medical and health care professionals, like psychologists, who submit valid claims. (Most of the fund will go to hospitals and large health care facilities.) Attorneys’ fees (up to 25% of the total settlement fund) and other administrative expenses (approximately $100 million) will also be deducted from the fund. This means the actual amount distributed to individual professionals will be significantly less than the headline $2.8 billion figure.

The amount you will receive then depends on three main factors: 1) the total charges you billed BCBS members between 2008 and 2024; 2) how BCBS practice may have affected reimbursements in your geographic area; and 3) the number and size of claims filed by other professionals. Here is a simplified breakdown of how we understand this three-step process:

• Points based on billings: First, points are assigned based on the total allowed amounts that you billed BCBS patients between 2008 and 2024; the more you billed (within certain ranges), the more points you get (1 point for under $250,000 to 5 points for over $1 million).
• Geographic adjustment: Your points are then adjusted based on a “harm coefficient” specific to your geographic location. This coefficient reflects the estimated impact of BCBS’s practices in that area and is converted into a multiplier from 1 to 5.3 depending on the severity (higher harm means a higher multiplier). The initial points are then multiplied by this geographic multiplier to determine your “adjusted points.” This considers both the amount you billed and the potential underpayment you experienced due to BCBS practices in your area.
• Final payment: Your final payment is calculated by dividing your adjusted points by the total adjusted points of all participating professionals. This result is then multiplied by the total settlement amount allocated to professionals (after deductions for fees and expenses). Therefore, the final payment reflects both the volume of services provided and the estimated degree of harm caused by BCBS’s alleged anticompetitive practices in the professional’s region.

The settlement accounts for the fact that many providers may not have complete records going back to 2008. Fortunately, the plaintiffs’ attorneys spent a significant amount of money on a database to track and estimate the claims submitted by most providers. The attorneys handling the case have a database with billing information from 2008–2014, and the settlement administrator can use this data to estimate billings up to 2024. This data helps in estimating the total allowed amounts for providers who may not have all their old records. For this reason, there are two ways to submit claims:

Default Method

If the database has your information from 2008–2014, you can use this method. (The system will estimate your allowed amounts for 2015–2024 and you will not need to provide additional documentation for those years.)

If you received a settlement notice in the mail, this is a good indication that you are in the database and likely eligible for compensation.

Alternative Method

If the database does not have your information from 2008–2014, you can still submit certain information for any years in the 2008–2024 timeframe for which you do have records or can attest to sufficient documentation in support of certain records. If you only have records for some years, the system will use the Consumer Price Index to estimate the missing years. More information on this method will be provided as it becomes available.

1. Determine eligibility: Verify that you fall within the settlement class (treated BCBS patients within the timeframe allotted) and are not excluded.
2. Choose the Default Method or Alternative Method and gather relevant information. Get your National Provider Identifier (NPI), Tax Identification Number (TIN), and, if necessary (and if using the Alternative Method), records of allowed charges for BCBS services together.
3. Complete the claim form: Submit the appropriate claim form (available online or by mail) by the deadline of July 29, 2025. BCBS encourages all claimants to submit their claims online.

Note that you will have a chance to review the calculated allowed amounts and request corrections if needed.

• Claim submission deadline: Claims must be submitted online or postmarked by July 29, 2025. For more information regarding the claim form, see BCBS’s Instruction Manualopens in new window.
• Exclusion request deadline: You can request to opt out of the settlement by doing so by March 4, 2025. This option appears to be mainly for those who wish to pursue their own antitrust claims against BCBS, which we expect few psychologists to do. The request must include specific information and a personal, physical signature.
• Objection deadline: If you would like to object to the settlement, you must send a written statement by March 4, 2025.

Psychologists should be on the lookout for other settlement notices that may affect their practice. APA Services will provide more information and guidance to help members navigate the claims process.

For more detailed instructions and to access claims forms, visit the settlement websiteopens in new window. You can also contact the Settlement Notice Administratoropens in new window or call toll-free at 1-888-452-3095.