Priyadarshan Tanvir

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OSSEM Orthopaedic Surgery, Sport & Exercise Medicine. Mike Reid Orthopaedics.

Address: Unit 11, Level 1/193-197 Lake St, Cairns City QLD 4870, Australia

In the 1960s, the U.S. government chose to partner with Blue Cross and Blue Shield companies to administer Medicare.[8] By September 2010, BCBS licensee Blue Cross and Blue Shield of North Carolina announced that it would refund $156 million to their policyholders[24] following documented charges: they had been sued and fined for denying due medical treatments to their customers and for underpaying doctors. [25][26] As of 2019 they were overseeing well over half of all payments for medical services in their state.[27] In 2019, Blue Cross and Blue Shield of North Carolina agreed to enter into a partnership with Cambia Health, but canceled the agreement later that year due to management issues at Cambia.[28] Companies outside of the United States publicly traded companies

Blue Cross is a name used by an association of health insurance plans throughout the United States. Its predecessor was developed by Justin Ford Kimball in 1929, while he was vice president of Baylor University's health care facilities in Dallas, Texas.[6] The first plan guaranteed teachers 21 days of hospital care for $6 a year, and was later extended to other employee groups in Dallas, and then nationally.[6] The American Hospital Association (AHA) adopted the Blue Cross symbol in 1939 as the emblem for plans meeting certain standards. In 1960, the AHA commission was superseded by the Blue Cross Association.

Blue Cross severed its ties with the AHA in 1972. In 1982, Blue Shield merged with The Blue Cross Association to form the Blue Cross and Blue Shield Association (BCBS).[9] Blue Cross and Blue Shield insurance companies are licenses, independent of the association and traditionally of each other,[14] offering insurance plans within defined regions under one or both of the association's brands. Blue Cross Blue Shield insurers offer some form of health insurance coverage in every U.S. state. They also act as administrators [15][14] of Medicare in many states or regions of the U.S.

Blue Cross of Idaho and Regence BlueShield Idaho[22] are separate companies and compete throughout the state. Regence BlueShield Idaho announced a strategic alliance (not a merger) with Blue Cross North Carolina.[23] In 1994, BCBS changed to allow its licenses to be for-profit corporations.[5] During 2010, Health Care Service Corporation, the parent company of BCBS in Texas, Oklahoma, New Mexico, Montana and Illinois, nearly doubled its income to $1.09 billion in 2010, and began four years of billion-dollar profits.[12] In the final spending bill for FY 2015 after much lobbying since 2010, nonprofit Blue Cross and Blue Shield plans continue to have special tax breaks that were understood to be threatened by the Affordable Care Act of 2010.[13] Prior to 1986, organizations administering BCBS were tax exempt under 501(c)(4) as social welfare plans. However, the Tax Reform Act of 1986 revoked the exemption, because the plans sold commercial-type insurance. They became 501(m) organizations, subject to federal taxation, but entitled to "special tax benefits"[10] under IRC 833.[11]

Blue Cross and Blue Shield developed separately, with Blue Cross providing coverage for hospital services and Blue Shield covering physicians' services.[5] Multi-state private companies The association has its headquarters in the Michigan Plaza complex in the Chicago Loop area of ​​Chicago, Illinois.[19] Single-state or regional companies

Blue Shield was developed by employers in lumber and mining camps of the Pacific Northwest to provide medical care by paying monthly fees to medical service bureaus composed of groups of physicians.[7][8] In 1939, the first official Blue Shield plan was founded in California. In 1948, the symbol was informally adopted by nine plans called the Associated Medical Care Plan, and was later renamed the National Association of Blue Shield Plans. Though historically "Blue Cross" was used for hospital coverage while "Blue Shield" was used for medical coverage,[29] today that split only exists for traditional health insurance plans in Pennsylvania. Two independent companies operate in central Pennsylvania, Highmark Blue Shield (Pittsburgh) and Capital Blue Cross (Central Pennsylvania). In southeastern Pennsylvania, Independence Blue Cross (Philadelphia) has a joint marketing agreement with Highmark Blue Shield (Pittsburgh) for their separate hospital and medical plans. However, Independence Blue Cross, like most of its sister Blue Cross Blue Shield companies, cover most of their customers under managed care plans such as HMOs and PPOs which provide hospital and medical care in one policy.

The Blue Cross Blue Shield Federal Employee Program (FEP) is a nationwide option under the Federal Employees Health Benefits Program (FEHB) for U.S. federal government employees and retirees, and has been part of FEHB since FEHB's inception in 1960.[16] FEP enrolls over half of the federal workforce, with over 5 million members, making it the largest insurer of federal employees and the largest single health plan group in the world.[3][16][17][18]

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