“From 2015 through 2023, the Baton Rouge-based insurer paid, on average, less than 9% of the charges billed by the breast center for more than 7,800 individual medical procedures — even though it had authorized all of them.”
Blue Cross Louisiana pre-authorized thousands of breast cancer procedures and paid less than 9% of the bills. A jury found fraud and awarded $421 million. Internal documents show it kept 16% of the savings when it underpaid for other Blue plans. Patients got billed for the rest.