Blue Cross Blue Shield

The Blue Cross Blue Shield Antitrust Litigation alleges that member health plans operating under the Blue Cross Blue Shield Association agreed to divide the country into exclusive geographic service areas and adopted rules limiting competition among Blue-branded plans, raising costs for both subscribers who bought coverage and healthcare providers who contracted with those plans. Centralized in the Northern District of Alabama in 2012, the docket carries 22 pending actions after more than a decade of litigation across two distinct plaintiff populations — subscribers and providers — whose claims have developed along different tracks within the same MDL.

For a funder, that subscriber/provider split matters directly for underwriting. Subscriber claims and provider claims rest on different theories of harm and different damages methodologies, and one track can be considerably further along than the other at any given time. A firm evaluating a claim in this docket needs to identify which plaintiff population — and which stage of that population's track — a given claim belongs to before pricing it, rather than treating the MDL as a single undifferentiated matter.

Where Blue Cross Blue Shield offers a genuine capital opportunity is provider-side inventory finance: hospital systems, physician groups, and other healthcare providers holding claims tied to below-market reimbursement rates allegedly caused by the market-allocation scheme represent a claim population large enough to support portfolio underwriting under Criterica Capital's commercial litigation finance line, once the specific track and its procedural posture are confirmed. A structure and litigation brief distinguishing the subscriber and provider tracks in more detail is also available.

Pre-settlement funding is a non-recourse purchase of a portion of the proceeds of a pending legal claim — not a loan. If the case does not result in a recovery, nothing is owed. Rates, fees, and repayment terms are disclosed in full in the funding agreement, which the applicant’s attorney reviews before signing. Availability and terms vary by state.