Blue Cross Blue Shield Antitrust Violation
Blue Cross Blue Shield Antitrust Violation Highlights
- In 2010, the Justice Department sued BlueCross BlueShield of Michigan, calling their most-favored nation clause anti-competitive.
- The department’s Michigan complaint said Blue Cross negotiated contracts with 70 of the state’s 131 general acute- care hospitals that led to higher prices for the insurer’s competitors.
- Health care fraud translates into higher premiums and copayments for consumers and reduced benefits and coverage

About Blue Cross Blue Shield Antitrust Violation
In October of 2010 the federal government filed a law suit against Blue Cross Blue Shield (BCBS) of Michigan for violating antitrust laws. The allegations came after an investigation into BCBS' "Most Favored Nation" clauses revealed that the clauses were creating an unfair advantage for BCBS.
The Most Favored Nation clause that BCBS placed in its contracts allowed hospitals to raise rates as long as the hike hit BCBS' competitors more. BCBS has negotiated contracts with over 50% of the hospitals in michigan, at times creating a rate difference as high as 30%-40%. This increase forced the competition to charge consumers higher premiums and co-payments while BCBS was able to keep their rates down and in effect offer the cheapest insurance.
While the suit against BCBS of Michigan is still under way the federal government has began investigating BCBS chapters in seven other states:
- District of Columbia
- Kansas
- Missouri
- Ohio
- North Carolina
- South Carolina
- West Virginia





