Blue Cross Blue Shield settlement information

BCBS settlement facilitator named
On September 8, 2008, the appointment of Deborah J. Winegard as the Class Compliance Dispute Facilitator (CDF) for the Blue Cross Blue Shield (BCBS) settlement was announced.

As an additional signatory to the settlement, the AMA is available to provide direct assistance to AMA physician members who wish to file a compliance dispute. Physicians interested in AMA assistance may contact the AMA Practice Management Center: 

American Medical Association
Practice Management Center
515 N. State Street, 13th Floor
Chicago, IL 60654
ATTN: BCBS Compliance Dispute
Fax: (312) 464-5541
E-mail: practicemanagementcenter@ama-assn.org

Please include the completed compliance dispute form (PDF, 34KB) and supporting documentation, if possible.

The direct contact information for BCBS CDF follows:

Deborah J. Winegard
c/o Neubert, Pepe & Monteith, PC
195 Church Street
New Haven, CT 06510
Fax: (203) 821-2009
Phone: (404) 607-8222
E-mail: dwinegard@gmail.com

Physicians may consider filing a compliance dispute if a settling health insurer’s contract contains prohibited clauses or if the health insurer fails to adhere to the terms of its settlement. After the CDF has deemed the dispute valid, the CDF will act as the physician’s representative, unless the physician or the signatory medical society acting on the physician’s behalf elects to employ separate counsel.

Please note: Although compliance disputes must generally be brought within 90 days of when the compliance dispute first arose or could reasonably have been known, the delay of the BCBS CDF enables physicians to raise compliance disputes that have arisen at any time after the Blue party was required to implement its obligations under the settlement agreement.

The BCBSA settlement Final Order
The Final Order was filed April 21, 2008 by a federal court in Miami and allows the signatory medical societies to directly assist physicians when a BCBS plan or subsidiary has failed to honor their commitments under the settlement.  The American Medical Association (AMA) has obtained court permission to participate in the enforcement of the national Blue Cross and Blue Shield (BCBS) settlement as an additional signatory medical society.

How the Blue Cross Blue Shield Settlement Agreement helps the physician practice (PDF, 51KB)

Blue Cross and Blue Shield settlement map