Blue Cross Hit With Antitrust Suit by Boston Children’s Hospital

Boston Children’s Hospital filed a federal antitrust complaint alleging Blue Cross Blue Shield and its 33 affiliated insurers schemed to suppress reimbursement payments.

Blue Cross Blue Shield underpaid the hospital “by literally billions of dollars” for treating patients, Boston Children’s said in a suit filed Monday in the US District Court for the District of Massachusetts.

“At the same time that they have been reimbursing Boston Children’s Hospital and its affiliates at low, anti-competitive rates, the Blues have enriched themselves, stockpiling billions of dollars in reserves and paying their senior executives exorbitant salaries, amounting to millions of dollars annually,” the complaint said.

The hospital is one of several plaintiffs that opted out of a $2.8 billion class action settlement that many providers reached with Blue Cross Blue Shield and its affiliates in October 2024 to resolve similar claims that the insurance giant deprived them of fair and competitive reimbursement rates.

A spokesperson for Blue Cross Blue Shield Association said the federation of insurers doesn’t comment on active litigation.

The $2.8 billion settlement, conditionally approved in December, marks the largest ever for a health-care antitrust case in the US. Judge R. David Proctor of the US District Court for the Northern District of Alabama set the final approval hearing for July 29.

Boston Children’s suit follows more than 15,000 similar “opt-out” requests from class members looking to be excluded from the settlement. Proctor in March ordered four law firms representing the majority of the requests represented by counsel—estimated to account for all but 2%—to state in writing whether their clients received funding from outside investors.

The class action settlement stems from an antitrust suit filed in 2012 on behalf of health-care providers alleging Blue Cross Blue Shield violated antitrust law by using geographic areas to dictate where a health insurance plan accepts members.

The latest suit brings claims under the federal Sherman Act as well as Massachusetts law.

Boston Children’s Hospital is represented by Quinn Emanuel Urquhart & Sullivan LLP.

The case is Children’s Hosp. Corp. v. Blue Cross Blue Shield Ass’n, D. Mass., 1:25-cv-11757, complaint filed 6/16/25.