Blues, Illi­nois sys­tem hit with an­titrust suit

Modern Healthcare - - LATE NEWS -

An am­bu­la­tory surgery cen­ter in Illi­nois filed an an­titrust law­suit against the state’s largest in­surer, Blue Cross and Blue Shield of Illi­nois, and the dom­i­nant health sys­tem in two south­ern coun­ties, al­leg­ing an il­le­gal busi­ness ar­range­ment to es­tab­lish a mo­nop­oly that in­creases con­sumers’ prices and pre­vents smaller health­care providers from en­ter­ing the mar­ket. Mar­ion Health­Care al­leges in its law­suit that three­hos­pi­tal South­ern Illi­nois Health­care, Car­bon­dale, has signed con­tracts with Blue Cross that force the in­surer to ex­clude smaller health­care providers from its net­work as a way to pre­serve its mo­nop­oly. Mar­ion also claims that Blue Cross has sent “threat­en­ing let­ters” to physi­cians warn­ing them not to treat pa­tients at out-of-net­work providers such as Mar­ion. The law­suit, filed Aug. 3 in U.S. Dis­trict Court in Ben­ton, Ill., states South­ern Illi­nois con­trols more than 85% of the mar­ket for out­pa­tient ser­vices in Wil­liamson and Jack­son coun­ties. Blue Cross has more than 6.5 mil­lion mem­bers in Illi­nois, a state with about 12.9 mil­lion res­i­dents, ac­cord­ing to the law­suit. Mary Ann Schultz, spokes­woman for Blue Cross and Blue Shield of Illi­nois and par­ent com­pany Health Care Ser­vice Corp., de­clined to com­ment on the law­suit. Rosslind Rice, spokes­woman for South­ern Illi­nois Health­care, said the health sys­tem does not com­ment on pend­ing lit­i­ga­tion. Mar­ion is seek­ing ac­tual and tre­ble dam­ages and an in­junc­tion against price dis­crim­i­na­tion by Blue Cross.

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