ZorroCard Round Up (10/28/24)

Hey all,

Happy Monday! I wanted to highlight a couple of lawsuits and an innovative subscription payment model for medications. Enjoy the rundown!

Jacob Brody(Co-Founder & CEO, ZorroCard)

BCBS Accused of ‘Ghost Network’ Fraud in Lawsuit (Fierce Healthcare)

In what must come as a massive surprise to New Yorkers desperately trying to find an in-network mental health provider, a class-action lawsuit alleges that Blue Cross Blue Shield has packed its provider directory with a “ghost network” of therapists—some who’ve apparently quit taking patients, left the field, or perhaps never existed in the first place. With that, BCBS members can continue enjoying the illusion of mental health support, complete with endless “sorry, not taking new patients” responses and voicemail purgatories. A reminder that transparency and support are alive and well at BCBS, right alongside their vanishing therapists. Full Article.

AMA Lawsuit Against MultiPlan Over Alleged Price-Fixing Cartel (Beckers)

The American Medical Association (AMA) and Illinois State Medical Society filed a lawsuit accusing MultiPlan of collaborating with health insurers to artificially lower payments for out-of-network healthcare services, reducing competition and harming providers financially. This lawsuit follows similar allegations from multiple healthcare systems, all now centralized in Illinois federal court for streamlined proceedings. In a surprise to no one, MultiPlan denies the claims, stating that these lawsuits are “meritless.” Full Article.

Curing Hepatitis C: The Netflix Model Explained (Healthcare Huddle) 

Jared Dashevsky, MD, explores the innovative “Netflix Model” for treating Hepatitis C, where states like Louisiana and Washington pay a fixed subscription fee to pharmaceutical companies for unlimited access to curative HCV medications. This model allows predictable budgeting for state healthcare programs and extends access to costly treatments among Medicaid and incarcerated populations, though early results have been mixed due to logistical hurdles and the pandemic. Dashevsky suggests this model could also be transformative for costly GLP-1 medications, like semaglutide, in Medicaid programs—potentially boosting access and outcomes for diabetes and obesity patients who struggle with similar access barriers. Full article.