Blue Cross/Blue Shield of Michigan: Hidden Surcharges for Self-Funded Insurance Customers
Recent discoveries into the billing practices at Blue Cross/Blue Shield of Michigan (BCBSM) reveal that it fraudulently charged certain administrative charges to its employer-customers who maintained self-funded medical insurance plans for their employees.
Many employers maintain self-funded medical insurance plans for their employees and contract with BCBSM to administer or operate their plans (i.e. process employee claims, make payments to doctors and hospitals etc.). Prior to 1994, BCBSM charged these employers a basic annual administrative fee for its services and in addition, charged various additional fees (“surcharges”) to bolster its (BCBSM’s) revenues to cover losses in its other lines of business. BCBSM disclosed these surcharges on its invoices. When employers complained and objected to the surcharges, BCBSM changed its billing practice by deleting any reference to the surcharges and instead began secretly marking up hospital claims to include the surcharge.
These hidden surcharges constitute a violation of the federal Employee Retirement Income Security Act (ERISA), and the first case involving these claims, Hi-Lex Controls v. BCBSM, went to trial in Detroit in April 2013, resulting in an award for the plaintiff-employer for the full amount of the hidden surcharges– more than $5 million – along with interest and attorneys’ fees.
The attorneys at Sommers Schwartz are actively investigating claims by other employers who maintained self-funded medical insurance plans for their employees and retained BCBSM as their plan administrator, to determine whether they, too, were fraudulently charged these hidden surcharges in violation of the law. If you believe that your company has been the victim of BCBSM’s unlawful billing practices, you need to act quickly to preserve and pursue your rights. Please contact us today to learn how we can help.
We fight hard. And we win.
News & Case Alerts
Read related articles and learn about recently filed cases.
Our attorneys have been featured on local and national media outlets, including:
I Cannot Say Enough Good Things About This Law Firm and My Attorney, Matthew G. Curtis.
I cannot say enough good things about this law firm and my attorney, Matthew G. Curtis. From the very beginning, their professionalism, communication, and attention to detail stood out immediately. They kept me informed throughout the entire process, answered my questions promptly, and always made me feel like a priority…
From a Wayne State Medical School Student About Judy Susskind
Law & Medicine was truly one of my favorite rotations – seeing a trial and learning from you was a privilege. Medical students are so lucky to have such an incredible preceptor for this experience. Your firm, colleagues, and clients are lucky to have you. (From a Wayne State University…
Praise for Tad Roumayah and Nathan Robbins
Tad Roumayah and Nathan Robbins are very professional and knowledgeable. They took charge from beginning to end with my employment case. I highly recommend them.
A Recommendation for Matthew Curtis and David Black
I highly recommend Matthew Curtis and David Black. They represented me in a legal malpractice case and did an outstanding job. They were very responsive, organized, efficient, and easy to work with throughout the entire process. What I appreciated most was that they were willing to take my case when…
Thank You, Jason Thompson
I just wanted to say thank you, Jason. The amount of work that you have done is astronomical, and it hasn’t gone unnoticed. We’ve always felt that you do what you say, take responsibility for your actions, even when you’re wrong, and that your word is your bond. (We found…
Heartfelt Thanks to Judy Susskind
Judy, I wanted to inform you that my mother passed away last night after losing a painful battle. She wanted me to specifically contact you and thank you for what you did for her. You took a chance and stood by her when no one else would, and you helped…
Praise for Nathan Robbins
One phone call made a world of difference! Thanks, Nate, for addressing and acknowledging my concerns! Great professionalism.
Praise for Judith Susskind
Ms. Susskind, your honesty, professionalism, and compassion meant a lot to me. I’m especially grateful for how thoroughly you reviewed my records and for the time you spent listening to my story. It’s been incredibly painful to reopen these wounds over and over and live them daily. Your kindness helped…
Our Clients Say It Best
