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.

A Trusted Authority

Our attorneys have been featured on local and national media outlets, including:

sommers-media-compressor

“Thank you from the bottom of my heart.”

I cannot begin to tell you how much I appreciate you! From our first conversation on the phone, I knew you truly believed me, and I felt comfortable sharing very personal and painful information with you. This was one of the hardest things that I’ve been through, but you made…

Thank you for looking out for me, and having my back.

Thank you for trying to win. Thank you for putting in as much time as you did. Thank you for being patient with me. Thank you for looking out for me, and having my back. You made a big impression on me.

Kenneth Watkins is very knowledgeable.

Being a healthcare professor myself, I was impressed to know that he was so well read and knew the medical jargon (terminology) when evaluating individual cases. I found him to be very professional, credible, and personable.

There is no one that will harder than attorney Jason Thompson.

There is no one that will harder than attorney Jason Thompson. He and his staff will work with you to make sure they get the best settlement possible.

You have no idea how much you and your team have helped me.

My husband and I had taken the advice of someone else over yours – only to later regret it. You got the results we wanted in three days after we wasted 7 weeks with someone else. You have no idea how much you and your team have helped me, and…

Andy Dragovic is an outstanding trial attorney!

I needed representation from an attorney who was empathetic and effective. Andrija Dragovic proved to be that attorney time and time again. He was clearly dedicated to finding justice, explored my options every step of the way, and respected all my decisions regarding the case.

My matter was handled and prosecuted above my expectations.

My matter was handled and prosecuted above my expectations and resulted in a positive outcome – other attorneys I contacted weren’t even interested in representing me. I would strongly recommend Sommers Schwartz and Mr. Watkins.

I will confidently recommend Sommers Schwartz.

You were on a short list of attorney’s I considered to represent me in this matter based on your standing in the legal community and I have no doubt that your reputation brought this matter to a resolution more expeditiously than a less highly regarded attorney would have been able to accomplish.

Should my son become half the lawyer as those I have met at your firm he will be successful.

My oldest son just passed the Colorado Bar. I firmly believe that should my son Chris become half the lawyer as those I have met at your firm he will be successful.

Our Clients Say It Best

googlereviews
40 5-star reviews on Google