Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-2_13-cv-20000/USCOURTS-alnd-2_13-cv-20000-9/pdf.json

Nature of Suit Code: 890
Nature of Suit: Other Statutory Actions
Cause of Action: 28:1331 Fed. Question

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§§§IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

IN RE: BLUE CROSS BLUE SHIELD ) Master File No. 2:13-CV-20000-RDP

ANTITRUST LITIGATION )

(MDL No. 2406) ) This document relates to the Provider Track

MEMORANDUM OPINION

This matter is before the court on Certain Defendants’1 Motion for Partial Summary 

Judgment. (Doc. # 2753). That Motion seeks to dismiss with prejudice the claims of certain 

named provider plaintiffs (the “Love Providers”),

2 who were also members of the settlement 

classes in Love v. Blue Cross and Blue Shield Association, et al., No. 1:03-cv-21296-FAM (S.D. 

Fla.) (“Love”). 

There were four separate settlement agreements encompassing different defendants in the 

Love case: the Blues Settlement Agreement (Doc. # 2221-4); the WellPoint Settlement 

Agreement (Doc. # 2221-6); the Highmark Settlement Agreement (Doc. # 2221-7); and the 

Capital Settlement Agreement (Doc. # 2221-8). The motion at issue here is based exclusively on 

the WellPoint and Capital Settlement Agreements. (Doc. # 2754 at 9; Doc. # 2822 at 8). As 

Certain Defendants explain, “The WellPoint and Capital Agreements contain no BlueCard 

1 As the court has previously referred to them for convenience in this litigation, “Certain Defendants” are 

Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Kansas, Inc., Blue Cross and Blue Shield of 

Kansas City, Blue Cross of Idaho Health Service, Inc., Blue Cross and Blue Shield of Nebraska, Blue Cross Blue 

Shield of North Dakota, Blue Cross Blue Shield of Wyoming, Highmark Western and Northeastern New York Inc. 

(formerly HealthNow New York Inc. d/b/a BlueCross BlueShield of Western New York and BlueShield of 

Northeastern New York), USAble Mutual Insurance Company d/b/a Arkansas Blue Cross and Blue Shield, 

Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield Delaware, Blue Cross and Blue Shield of Vermont, 

California Physicians’ Service d/b/a Blue Shield of California, and Excellus Health Plan, Inc. d/b/a Excellus 

BlueCross BlueShield.

2 The “Love Providers” are Charles H. Clark III, M.D., Robert W. Nesbitt, M.D., Luis R. Pernia, M.D., 

Corey Musselman, M.D., Julie McCormick, M.D., L.L.C., Harbir Makin, M.D., Hillside Family Medicine, LLC, 

Ear, Nose & Throat Consultants and Hearing Services, P.L.C., and Kathleen Cain, M.D. (Conway v. Blue Cross and 

Blue Shield of Alabama et al, Case No. 2:12-cv-02532-RDP, Doc. # 457 at & 559). 

FILED

 2022 Feb-16 PM 12:13

U.S. DISTRICT COURT

N.D. OF ALABAMA

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Exception, and they therefore release the second category of claims preserved by the Blue 

Agreement that does contain the BlueCard Exception (claims arising from services provided to 

the settling defendants’ members through BlueCard).” (Doc. # 2822 at 8; see also Doc. # 2324 at 

14 (“WellPoint and Capital BlueCross executed separate settlement agreements which did not 

contain BlueCard Exceptions”); Doc. # 2221-6 at § 13.1; Doc. # 2221-8 at § 9.1).

I. Relevant Undisputed Facts

In May 2003, a group of medical providers filed an action in the Southern District of 

Florida against numerous Blue entities, alleging that several managed care companies had 

engaged in a scheme to systematically deny, delay, and diminish payments to healthcare 

providers. Love v. Blue Cross & Blue Shield Ass’n, Case No. 1:03-cv-21296-FAM (S.D. Fla.). 

The Love case was consolidated into the In re Managed Care Litigation MDL, Case No. 

1:00-mdl-1334 (S.D. Fla.). (Doc. # 2120 at 5). The litigation was assigned to Judge Frederico A. 

Moreno, a distinguished judge sitting in the Southern District of Florida. Judge Moreno 

described the litigation this way: “This MDL case concerned, inter alia, reimbursement for 

health care services by managed care companies and was divided into two tracks: one involving 

broad claims by health care providers and the other involving broad claims by subscribers to 

health care plans. The provider track litigation, namely Love, was a class action brought on 

behalf of all providers who submitted claims to health care companies, including the [defendants 

in Conway v. Blue Cross Blue Shield of Alabama, Case No. 2:12-cv-02532 (N.D. Ala.),3] for the 

3 Conway v. Blue Cross and Blue Shield of Alabama et al., Case No. 2:12-cv-02532-RDP, is one of the 

prioritized Alabama Provider cases in this litigation, In Re Blue Cross Blue Shield Antitrust Litigation MDL 2406. 

(Doc. # 575). 

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provision of medical services.” Musselman v. Blue Cross & Blue Shield of Alabama, 2013 WL 

4496509, at *1 (S.D. Fla. Aug. 20, 2013), aff’d, 684 F. App’x 824 (11th Cir. 2017). 

Between 2005 and 2008, certain Blue defendants in Love entered into settlement 

agreements with provider plaintiffs. (Doc. # 2120-1 at 2). “Under each agreement, the 

Defendants agreed to make substantial payments to the class members and their counsel and to 

implement numerous business practice initiatives. Pursuant to these agreements, Defendants paid 

class members and their counsel more than $384 million in cash and spent more than $535 

million making business practice changes that the Love plaintiffs stated had a value to the 

settlement class of more than $3.4 billion.” Musselman 2013 WL 4496509, at *1.

A. The WellPoint Settlement

On July 11, 2005, “Representative Plaintiffs” in Love, Rick Love, M.D., Joe Frank Smith, 

M.D., Scott Elledge, M.D. and Andreas Melendez-Desos, M.D., “on behalf of themselves and 

each of the Class Members,” entered into a class settlement with WellPoint, Inc. and its affiliates 

(the “WellPoint Settlement Agreement” or “WSA”), which was granted final approval by the 

Love court in December 2005. (Doc. # 2221-7; Doc. # 2795-2). 

The Love court certified the following WellPoint settlement class:

Any and all Physicians, Physician Groups and Physician Organizations who 

provided Covered Services to any Plan Member or any other individual enrolled 

in or covered by a plan offered or administered by any Person named as a 

defendant in the [Love] Complaints or by any of their respective current or former 

Subsidiaries or Affiliates, in each case from August 4, 1990 through the 

Preliminary Approval Date [December 31, 2005].

(Doc. # 2795 at 5, & 2).

Under the WellPoint Settlement Agreement, “Released Parties” include WellPoint 

entities that were defendants in Love (the “WellPoint Released Parties”). (Doc. # 2221-7 at §§ 

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1.27, 13.1(a)). On December 27, 2005, the Love court entered a final judgment dismissing the 

WellPoint Released Parties with prejudice. (Doc. # 2795-2). Many of the WellPoint Released 

Parties are defendants in this MDL, and through corporate changes now operate under the 

Anthem name. (Conway v. Blue Cross and Blue Shield of Alabama et al, Case No. 

2:12-cv-02532-RDP, Doc. # 457 ¶¶ 47, 55, 57-59, 64, 69, 72, 74, 80, 85-86, 96, 110, 113).

Turning to the language of the WellPoint Settlement Agreement, “Released Parties” as 

used in that document are defined as:

Company and each of its present and former parents, present and former 

wholly-owned Subsidiaries, present and former divisions and Affiliates and each 

of their respective current or former officers, directors, employees, agents, 

insurers and attorneys (and the predecessors, heirs, executors, administrators, 

legal representatives, successors and assigns of each of the foregoing), and all 

persons who provided claims processing services, software, proprietary guidelines 

or technology to Company or its Subsidiaries and Affiliates, and those contracted 

agents processing claims on their behalf, together with each such person’s or 

entity’s predecessors or successors (but only to the extent of such person’s or 

entity’s services and work done pursuant to contract with Company or its 

Subsidiaries or Affiliates), but excluding all Delegated Entities, shall be released 

and forever discharged by the Signatory Medical Societies and all Class Members 

who have not validly and timely requested to Opt-Out of this Agreement, and by 

their respective heirs, executors, agents, legal representatives, professional 

corporations, partnerships, assigns, and successors, but only to the extent such

claims are derived by contract or operation of law from the claims of Class 

Members ... .

(Doc. # 2221-6 at 75 § 13.1(a)). Also under the WellPoint Settlement Agreement, the Releasing 

parties agreed:

to forever abandon and discharge any and all Claims that exist now or that might 

arise in the future against BCBSA and/or any Blue Cross and/or Blue Shield 

licensee or wholly-owned subsidiary of such licensee, which Claims arise from, or 

are based on, conduct by any of the Released Parties that occurred on or before 

the Effective Date and are, or could have been, alleged in the Complaints, whether 

any such Claim was or could have been asserted by any Releasing Party on its 

own behalf or on behalf of other Persons.

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(Doc. # 2221-6 at 76 § 13.1(b)) (emphasis added). Further, the “Bar Order” section of the 

WellPoint Settlement Agreement provides: 

It is an essential element of the Agreement that Company obtain the fullest 

possible release from further liability to anyone relating to the Released Claims, 

and it is the intention of the parties to this Agreement that the Agreement 

eliminate all further risk and liability of Company relating to the Released Claims.

(Doc. # 2221-6 at 76 § 13.3).

In Judge Moreno’s Amended Final Approval Order, which approved the WellPoint 

Settlement, he noted that:

The Releasing Parties further agree[d] to forever abandon and discharge any and 

all Claims that exist now or that might arise in the future against BCBSA and/or 

any Blue Cross and/or Blue Shield licensee or wholly-owned subsidiary of such 

licensee, which Claims arise from, or are based on, conduct by any of the 

Released Parties that occurred on or before the Effective Date and are, or could 

have been, alleged in the Complaints, whether any such Claim was or could have 

been asserted by any Releasing Party on its own behalf or on behalf of other 

Persons.

(Doc. # 2795-2 at 7, ¶ 6) (emphasis added). The Amended Final Approval Order also notes that 

“[n]othing in the Settlement Agreement prevents the Plaintiffs and the Class from pursuing 

claims to hold any person or party that is not either a Released Party, BCBSA, or a Blue Cross 

and/or Blue Shield licensee or wholly owned subsidiary of such licensee liable for damages 

caused by any Released Party.” (Doc. # 2795-2 at 9, ¶ 15) (emphasis added). 

Despite the broad language of the release, the only Blue licensees who were dismissed in 

Love as a result of the WellPoint Settlement Agreement were WellPoint-related entities (the 

“Released Parties”). (Doc. # 2795-3). 

B. The Capital Settlement

On February 1, 2008, “Representative Plaintiffs” in Love, Rick Love, M.D., Joe Frank 

Smith, M.D., Scott Elledge, M.D. and Andreas Melendez-Desos, M.D., “on behalf of themselves 

Case 2:13-cv-20000-RDP Document 2902 Filed 02/16/22 Page 5 of 23
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and Class Members,” entered into a class settlement with Capital BlueCross, Capital Advantage 

Insurance Company and Keystone Health Plan Central (the “Capital Settlement Agreement” or 

“CSA”), which was granted final approval by the Love court in June 2008. (Doc. # 2221-8; Doc. 

# 2795-4). 

The Love court certified the following Capital settlement class: 

Any and all Physicians, Physician Groups and Physician Organizations who 

provided Covered Services to any Plan Member or to any individual enrolled in or 

covered by a Plan offered or administered by any Person named as a defendant in 

the [Love] Complaint or by any other primary licensee of the BCBSA or by any of 

their respective current or former subsidiaries or Affiliates, from January 1, 1996 

through March 12, 2008. 

(Doc. # 2795-4 at 7, ¶ 2).

A review of the Capital Settlement Agreement shows that “Released Parties” include 

Capital BlueCross, Capital Advantage Insurance Company, and Keystone Health Plan Central

(the “WellPoint Released Parties”). (Doc. # 2221-8 at 2, 10 (§ 9.1). On June 23, 2008, the Love

court entered a final judgment dismissing these entities with prejudice. (Doc. # 2795-4). 

Under the Capital Settlement Agreement, “Released Parties” are defined as:

Blue Plan and each of their present and former parents, subsidiaries, divisions and 

Affiliates and each of their respective current or former officers, directors, 

employees, agents, insurers and attorneys (and the predecessors, heirs, executors, 

administrators, legal representatives, successors and assigns of each of the 

foregoing), and all Persons who provided claims processing services, software, 

proprietary guidelines or technology to Blue Plan, their subsidiaries or Affiliates, 

and those contracted agents processing claims on their behalf (including, without 

limitation NASCA), together with each such person’s or entity’s predecessors or 

successors (but only to the extent of such person’s or entity’s services and work 

done pursuant to contract with Blue Plan or their Subsidiaries or Affiliates), but 

excluding all Delegated Entities, shall be released and forever discharged by all 

Class Members, and by their respective current and former officers, directors, 

employees, attorneys, heirs, executors, administrators, agents, legal 

representatives, professional corporations, partnerships, assigns and successors, 

but only to the extent such claims are derived by contract or operation of law from 

the claims of Class Members ... .

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(Doc. # 2221-8 at 10 (§ 9,1)). Also under the Capital Settlement Agreement, the Releasing 

parties agreed:

to forever abandon and discharge any and all Claims that exist now or that might 

arise in the future against any other persons or entities, which Claims arise from, 

or are based on, conduct by any of the Released Parties that occurred on or before 

the Effective Date and are, or could have been, alleged in the Complaints, whether 

any such Claim was or could have been asserted by any Releasing Party on its 

own behalf or on behalf of other Persons.

(Doc. # 2221-8 at 11 (§ 9.1(b)) (emphasis added). Further, the “Bar Order” section of the Capital

Settlement Agreement provides: 

The Parties intend that this Agreement eliminate all further risk and liability of the 

Released Parties relating to the Released Claims ... .

(Doc. # 2221-8 at 11 (§ 9.3)).

In his Final Approval Order regarding the Capital Settlement Agreement, Judge Moreno

noted that “Any claims released or discharged pursuant to Sections 9.1(a) and 9.1(b) of the 

Settlement Agreement shall be referred to collectively as “Released Claims.” (Doc. # 2795-4 at 

9, ¶ 6). Of course, Section 9.1(b) addresses “any and all Claims that exist now or that might arise 

in the future against any other persons or entities, which Claims arise from, or are based on, 

conduct by any of the Released Parties ... .” (Doc. # 2221-8 at 11 (§ 9.1(b) (emphasis added))).

Despite the broad language of the release, the only Blue licensees who were dismissed in 

Love as a result of the Capital Settlement Agreement were Capital-related entities (the “Released 

Parties”). (Doc. # 2795-5). 

The four Love settlement agreements all generally contain similar release language. (Doc. 

# 2221-4 at § 13.1; Doc. # 2221-6 at § 13.1; Doc. # 2211-7 at § 13.1; Doc. # 2221-8 at § 9.1).

Notably, however, the WellPoint and Capital agreements do not contain the first sentence of 

Section 13.1(b) contained in the Blues Settlement Agreement, which has become known as the 

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“BlueCard Exception.” (Compare Doc. # 2221-6 at § 13.1 and Doc. # 2221-8 at § 9.1 with Doc. 

# 2221-4 § 13.1(b)).

Non-Settling Defendants did not move for dismissal in Love based on either the 

WellPoint Settlement Agreement or the Capital Settlement Agreement after the Love “Plaintiffs 

filed an Amended Complaint removing references to WellPoint following the WellPoint 

settlement[.]” (Doc. # 2824-2 at 2, n.1; see also Doc. # 2824-13 at 5 (“The requested 

amendments seek to: 1) remove defendants who are affiliated with WellPoint ... .”); (Doc. # 

2221-10 at 9 (“The Plaintiffs should have hastened to correct their pleadings and motions to 

remove all allegations premised on conduct by BCBSA, as they did with WellPoint. Since they 

have not, this Court’s intervention is necessary to enforce the Settlement and Final Approval 

Order.”)). 

C. Litigation Over the Love Release Language

On April 27, 2007, after the WellPoint Settlement in 2005 and before the Capital 

Settlement in 2008, the Love physician plaintiffs entered into a class settlement with BCBSA, 

BCBS-AL, and additional Blue Plans (the “Blue Settlement Agreement” or “BSA”), which was 

granted final approval by the Love court on April 19, 2008. (Doc. # 2221-4; Doc. # 2221-5). The 

second sentence of Section 13.1(b) of the Blue Settlement Agreement contains language almost 

identical to that found in Section 13.1(b) of the Capital Settlement Agreement. (Doc. # 2221-4 at 

§ 13.1; Doc. # 2221-8 at § 13.1). The Blues Settlement Agreement Section 13.1(b) provides: 

[T]he Releasing Parties further agree to forever abandon and discharge any and all 

Claims that exist now or that might arise in the future against any other Persons 

which Claims arise from, or are based on, conduct by any of the Released Parties 

that occurred on or before the Effective Date and are, or could have been, alleged 

in the Complaint, whether any such Claim was or could have been asserted by any 

Releasing Party on its own behalf or on behalf of other Persons.

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(Doc. # 2221-4 at § 13.1(b) (emphasis added)). 

On June 16, 2008, the Love plaintiffs filed a Sixth Amended Complaint against the 

Non-Settling Defendants alleging that BCBSA was the “hub” of a RICO and fraud conspiracy 

among all Blue Plans to undercompensate physicians for their services. (Doc. # 2221-9 at ¶¶ 17, 

163, and 203). The Love Sixth Amended Complaint also alleged that BCBSA’s BlueCard 

Program, the electronic network for claims processing and reimbursement, was central to the 

success of the conspiracy. (Doc. # 2221-9 at ¶ 201). 

On July 28, 2008, BCBSA moved to enforce the Blues Settlement Agreement on the 

grounds that Section 13.1(b) of that Agreement barred the claims in the Love Sixth Amended 

Complaint, even against Non-Settling Defendants, because those claims were alleged to “arise 

from, or are based on” conduct of BCBSA. (Doc. # 2221-10). In their response, the Love

plaintiffs did not argue that Section 13.1(b) did not operate to bar claims against the Non-Settling 

Defendants. Rather, they asserted that the claims in the Sixth Amended Complaint fell within 

Section 13.1(b)’s so-called BlueCard Exception in the first sentence of that paragraph, which 

excepts “[c]laims for damages against defendants in the [Love] Action that are not Parties [to the 

settlement] relating to providing Covered Services to Blue Plans’ Plan Members in connection 

with the BlueCard Program....” (Doc. # 2221-11 at 6). 

Magistrate Judge Edwin G. Torres issued a report and recommendation on BCBSA’s 

motion to enforce in which he noted that “the language of the Court’s Final Approval Order and 

the Settlement Agreement clearly prohibits Class members from initiating claims against any 

party, both ‘Released’ and ‘Non-Released,’ which ‘arise from, or are based on, conduct by any 

of the ‘Released Parties.’” (Doc. # 2221-12 at 5) (emphasis added). Nonetheless, Judge Torres 

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recommended that BCBSA’s motion be denied because the Love Sixth Amended Complaint’s 

claims fell within the BlueCard Exception. (Doc. # 2221-12). Judge Moreno “affirmed and

adopted” Judge Torres’s Report and Recommendation. (Doc. # 2221-13).

On January 7, 2013, three Love settlement class members, Corey Musselman, M.D., Rick 

Love, M.D., and Charles Shane, M.D., filed suit in Musselman v. Blue Cross and Blue Shield of 

Alabama, et al., Case No. 1:13-cv-20050-FAM (S.D. Fla.), against the Love Settling Defendants 

seeking a declaration that Providers’ antitrust claims in Conway, Case No. 2:12-cv-02532-RDP

(a part of this MDL), are not “Released Claims” as defined in the Love Settlement Agreements. 

(Doc. # 2221-16 at ¶ 2). Judge Moreno dismissed the Musselman Complaint. He held that 

Providers’ claims in Conway against the Love Settling Defendants were released in the Love

Settlement Agreements. Musselman, 2013 WL 4496509, at *8 (“Pursuant to the plain language 

of the releases and the prior decisions of this Court and the Eleventh Circuit, the Court holds that 

the claims asserted in Conway are Released Claims.”).4 The Eleventh Circuit affirmed “on the 

basis of the District Court’s thorough and well-reasoned order [].” Musselman v. Blue Cross & 

Blue Shield of Alabama, 684 F. App’x 824, 825 (11th Cir. 2017). 

4

In Musselman, Judge Moreno noted:

[T]he Eleventh Circuit has rejected the argument that the release does not apply simply because a 

lawsuit involves different allegations than Love or asserts a different cause of action. The 

determination of whether a claim is a Released Claim under the language of the Settlement 

Agreement depends not on the cause of action alleged but on the nucleus of operative fact 

underlying the claim. See Thomas [v. Blue Cross & Blue Shield Ass’n, 594 F.3d 814, 822 (11th 

Cir. 2010)]. In Health Care Serv. Corp. v. Kolbusz, 594 F.3d 814, 822 (11th Cir. 2010), the 

Eleventh Circuit held that, under the broad language of the release, tortious interference and 

defamation claims were Released Claims even though such claims had never been asserted in 

Love, stating that it was “irrelevant that [plaintiff’s] claims depend on a different legal theory than 

the claims asserted in the class action or require [the plaintiff] to prove matters in addition to or 

different from the claims asserted in the class action.”

Musselman v. Blue Cross & Blue Shield of Alabama, 2013 WL 4496509, at *5 (S.D. Fla. Aug. 20, 2013), aff’d, 684 

F. App’x 824 (11th Cir. 2017).

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On April 18, 2017, Provider Plaintiffs filed an amended complaint in this MDL, which 

states that the Love Providers bring claims against only the Non-Settling Love Defendants. 

(Conway, Case No. 2:12-cv-02532-RDP, Doc. # 457 at ¶¶ 43, 559). On April 25, 2018, Provider 

Plaintiffs filed a Motion for Partial Summary Judgment against Certain Defendants That Were 

Not Signatories to Settlement Agreements in Love v. Blue Cross and Blue Shield Association.

(Doc. # 2120). Provider Plaintiffs argued that the Non-Settling Love Defendants’ release, waiver, 

res judicata, or collateral estoppel affirmative defenses failed because they were not signatories 

to the Love Settlement Agreements. Id. On October 17, 2018, this court denied Provider 

Plaintiffs’ motion “for two reasons. First, Providers’ claims in this MDL fall squarely within the 

scope of the Love releases because they arise from, or are based on, conduct by the Released 

Parties. Musselman, 2013 WL 4496509, at *8. Second, not all of Providers’ claims” fall within 

the BlueCard Exception. (Doc. # 2324 at 11-12).

D. Love Providers Who Are Named Plaintiffs in Conway

The operative Conway Complaint in this MDL alleges that “[c]ertain of the named 

Provider Plaintiffs [] were members of the Settlement classes in class settlements with some of 

the Defendants consummated in” Love. (Conway, Case No. 2:12-cv-02532-RDP, Doc. # 457 at 

¶¶ 43, 559). That is, the Love Providers are members of the WellPoint and Capital settlement 

classes. 

In Conway, the Love Providers and other Provider Plaintiffs allege that the Non-Settling 

Love Defendants are liable for alleged participation in two purported nationwide conspiracies 

involving all defendants and resulting in alleged unlawful agreements among all defendants to 

restrict competition: (1) the “Market Allocation Conspiracy” and (2) the “Price Fixing and 

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Boycott Conspiracy.” (Conway, Case No. 2:12-cv-02532-RDP, Doc. # 457 at ¶¶ 1, 4, 8). They 

further allege that both conspiracies were carried out through the conduct of all defendants, 

including Anthem and Capital. (See, e.g., id. at ¶ 328 (“Defendants achieved the Price Fixing and 

Boycott Conspiracy by agreeing that all Defendants would participate in the national programs 

including the Blue Card and National Accounts Programs . . . .”); ¶ 5 (“In furtherance of the 

Market Allocation Conspiracy, Defendants agreed that each Defendant would be allocated a 

defined Service Area and further agreed . . . not to compete with each other within those 

markets.”); ¶ 20 (“[A]ll of the Defendants have conspired with Blue Cross and Blue Shield of 

Alabama.”); and ¶ 523 (“All Defendants have taken overt acts in furtherance of this conspiracy 

by signing the various agreements that restrict competition among them.”)). Provider Plaintiffs

have explicitly identified the alleged conduct of both Capital and Anthem as bases of their 

claims. (Id. at ¶ 288 “Capital Blue Cross has attempted to operate outside of its Service Area” 

but subsequently “agreed to restrict its competition” and would compete with other Blue Plans 

“if it were not for the agreement not to expand outside of each Blue’s Service Area.”); ¶ 118 

(“But for the illegal territorial restrictions summarized above, Anthem would be likely to offer its 

health care financing throughout the United States in competition with the other Blues, including 

in Alabama . . . If Anthem did develop and operate a Provider Network in Alabama, it would 

provide increased competition, and such competition would result in higher payments to 

Providers.”); ¶ 358 (“Evidence will be introduced that shows Anthem is prevented from crossing 

the Georgia line to compete in Alabama, and other empirical evidence is consistent with all the 

other Blues agreeing not to compete in Alabama in health insurance markets as well.”)).

Case 2:13-cv-20000-RDP Document 2902 Filed 02/16/22 Page 12 of 23
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The Love Providers and the other Provider Plaintiffs do not dispute that their Market 

Allocation Conspiracy claims are based on Defendants’ alleged agreement to allocate geographic 

markets among themselves. (Doc. # 2306 at 7, ¶ 3). They state that their monopsonization claims 

are not based “solely” on Defendants’ alleged agreement to allocate geographic markets among 

themselves, yet they do not dispute that the claims are based in part on Defendants’ alleged 

agreement. (Id. at ¶ 4).

II. Standard of Review

Under Federal Rule of Civil Procedure 56, summary judgment is proper “if the pleadings, 

depositions, answers to interrogatories, and admissions on file, together with the affidavits, if 

any, show that there is no genuine issue as to any material fact and that the moving party is 

entitled to judgment as a matter of law.” Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). The 

party asking for summary judgment always bears the initial responsibility of informing the court 

of the basis for its motion and identifying those portions of the pleadings or filings which it 

believes demonstrate the absence of a genuine issue of material fact. Id. at 323. Once the moving 

party has met its burden, Rule 56 requires the non-moving party to go beyond the pleadings and 

– by pointing to affidavits, or depositions, answers to interrogatories, and/or admissions on file –

designate specific facts showing that there is a genuine issue for trial. Id. at 324. 

The substantive law will identify which facts are material and which are irrelevant. See 

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986) (“Anderson”). All reasonable doubts 

about the facts and all justifiable inferences are resolved in favor of the non-movant. See Allen v. 

Bd. of Pub. Educ. for Bibb Cty., 495 F.3d 1306, 1314 (11th Cir. 2007); Fitzpatrick v. City of 

Atlanta, 2 F.3d 1112, 1115 (11th Cir. 1993). A dispute is genuine “if the evidence is such that a 

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reasonable jury could return a verdict for the nonmoving party.” Anderson, 477 U.S. at 248. If 

the evidence is merely colorable, or is not significantly probative, summary judgment may be 

granted. See id. at 249.

III. Analysis

In their Consolidated Fourth Amended Provider Complaint, Provider Plaintiffs have 

offered the following brief description of their claims in this MDL:

In the claims related to the Market Allocation Conspiracy, Plaintiff healthcare 

providers challenge the explicit agreement reached by Defendants to divide the 

United States into what Defendants term “Service Areas” and then to allocate 

those geographic areas among the Blues, free of competition. In the claims related 

to the Price Fixing and Boycott Conspiracy, Plaintiffs also challenge the 

agreement reached by Defendants to fix prices for goods, services and facilities 

rendered by healthcare providers such as Plaintiffs and to boycott the healthcare 

providers outside of their Service Areas.

(Doc. # 1083 at ¶ 4). Count One of that pleading is a “Claim for Injunctive Relief, 15 U.S.C. §

26.” (Doc. # 1083 at ¶¶ 460-465). Provider Plaintiffs’ remaining claims, asserted in Counts II 

through X, all seek treble damages. (Doc. # 1083 at ¶¶ 466-526). 

A. The Love Providers’ Claims Fall Within the Scope of the WellPoint and 

Capital Releases

As an initial matter, Certain Defendants note that this court has already held that 

“Providers’ claims in this MDL fall squarely within the scope of the Love releases because they 

arise from, or are based on, conduct by the Released Parties.” (Doc. # 2754 at 21 (quoting Doc. # 

2324 at 11)). Second, they point out that this court has “held that Love Settlement Agreements 

‘clearly prohibit[] Class members from initiating claims against’ non-signatories, including the 

Non-Settling Love Defendants.” (Id. (quoting Doc. # 2221-12 at 6)). And third, they observe that 

this court has previously “rejected provider plaintiffs’ argument that their claims in this MDL are 

preserved by Love Settlement Agreement release language retaining claims for the Non-Settling 

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Love Defendants’ ‘own conduct or conduct of other Persons who are not Released Parties.’” (Id. 

(quoting Doc. # 2221-12 at 12-13)). Defendants have further referenced the court’s explanation 

about this third point: “while this language retains claims against a Non-Settling Love Defendant 

‘for [its] own, separate conduct,’ it does not preserve claims that Non-Settling Love Defendants 

acted ‘in conjunction with the Released Parties.’” (Id. (quoting Doc. # 2221-12 at 12-13)).

As they did in briefing on their previous motion, the Love Providers strive mightily to 

distance themselves from the actual language of the releases at issue. In response to Certain 

Defendants’ initial argument, the Love Providers contend that their “claims for services provided 

to persons enrolled in or covered by a plan other than the Released Parties in the WellPoint and 

Capital Settlement Agreements are not barred by those agreements.” (Doc. # 2799 at 19-20). 

Rather, they argue the Non-Settling Defendants are simply third-party beneficiaries of the

WellPoint and Capital Settlement Agreements. (Id. at 20-21). And, they also contend that the 

Non-Settling Defendants should be estopped from making an argument not previously made. (Id.

at 22) (“Until now, no Blue Plan has ever moved for dismissal based on the WellPoint or Capital 

Settlement Agreements other than the Released Parties.”). 

In reply, Certain Defendants re-orient the court to the actual release language. The 

WellPoint and Capital releases do not limit their application to services provided to WellPoint or 

Capital subscribers. Under the WellPoint Settlement Agreement, the Releasing Parties agreed:

to forever abandon and discharge any and all Claims that exist now or that might 

arise in the future against BCBSA and/or any Blue Cross and/or Blue Shield 

licensee or wholly-owned subsidiary of such licensee, which Claims arise from, or 

are based on, conduct by any of the Released Parties that occurred on or before 

the Effective Date and are, or could have been, alleged in the Complaints, whether 

any such Claim was or could have been asserted by any Releasing Party on its 

own behalf or on behalf of other Persons.

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(Doc. # 2221-6 at 76 § 13.1(b)) (emphasis added). Under the Capital Settlement Agreement, the 

Releasing Parties agreed:

to forever abandon and discharge any and all Claims that exist now or that might 

arise in the future against any other persons or entities, which Claims arise from, 

or are based on, conduct by any of the Released Parties that occurred on or before 

the Effective Date and are, or could have been, alleged in the Complaints, whether 

any such Claim was or could have been asserted by any Releasing Party on its 

own behalf or on behalf of other Persons.

(Doc. # 2221-8 at 11 (§ 9.1(b) (emphasis added))). 

At least in some key respects, the court finds itself refereeing a familiar skirmish, albeit 

in a slightly different (but not materially distinguishable) context. As this court stated previously, 

[T]the court begins its analysis by observing the fundamental proposition that it 

must construe a contract to give meaning to each word. That is, a construction of 

a contract that would render a clause meaningless would violate a foundational 

rule of contract interpretation. See Equity Lifestyle Props., Inc. v. Fla. Mowing 

and Landscape Serv., Inc., 556 F.3d 1232, 1242 (11th Cir. 2009) (“[This court] 

must read the contract to give meaning to each and every word it contains, and ... 

avoid treating a word as redundant or mere surplusage ‘if any meaning, 

reasonable and consistent with other parts, can be given to it.’” (quoting Roberts 

v. Sarros, 920 So.2d 193, 196 (Fla.Dist.Ct.App.2006))).

Moreover, in addressing Providers’ Motion, this court is cognizant that it is not 

writing on a blank slate. As to the scope of the Love releases, in Musselman, 

Judge Moreno held “that the Conway claims are Released Claims” under the Love

Settlement Agreement. 2013 WL 4496509, at *3. More specifically, as Judge 

Moreno explained:

[T]the claims in Conway are also released. Conway arises out of and 

relates to the “facts, acts, events ... or other matters” in Love. Conway is 

based on Plaintiffs’ allegation that Defendants conspired to “suppress 

competition and to increase their profits ... by decreasing the rates paid to 

healthcare providers....” Conway Am. Compl. ¶ 226. Love was based on 

the similar allegation that the defendants had engaged in a common 

scheme to systematically deny, delay, and diminish the payments due to 

doctors. See Love Compl. ¶ 5. In short, both complaints are based on 

allegations that Defendants, acting through BCBSA, conspired to reduce 

provider reimbursement. As a result, Conway falls within the scope of the 

first sentence of the release.

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Id., at *5. Judge Moreno further found that “[t]he Settlement Agreement is clearly 

intended to embrace all potential claims and not merely those that were expressly 

pled at the time the record was frozen based on the parties’ decision to conduct 

settlement negotiations.” Id., at *6.

In Love, Judge Torres and Judge Moreno each addressed the specific question of 

whether the Settlement Agreement prohibits claims against Non-Released 

Defendants. Judge Torres found that “[t]he language of the Court’s Final 

Approval Order and the Settlement Agreement clearly prohibits Class members 

from initiating claims against any party, both “Released” and “Non-Released,” 

which “arise from, or are based on, conduct by any of the ‘Released Parties.’” 

(Doc. # 2221-12 at 5 (citing judge Moreno’s Final Approval Order ¶ 6 and the 

Settlement Agreement § 13.1(b)) (emphasis added).

(Doc. # 2324 at 10-11). 

Based on this broad release language in the WellPoint and Capital Settlement 

Agreements, the court rejects Providers’ contention that “the scope of any potential bar for 

non-released parties is necessarily limited to services provided to the insureds of Released 

Parties.” (Doc. # 2799 at 23). The court understands quite clearly that its prior analysis related to 

the Blues Settlement Agreement. However, the language contained in the WellPoint and Capital 

Settlement Agreements is similarly broad. Thus, consistent with this court’s previous opinion 

regarding the scope of the Blues Settlement Agreement in Love, and the opinions of Judges

Moreno and Torres, the court concludes that the Love Providers’ claims in this MDL fall 

squarely within the scope of the WellPoint and Capital Settlement Agreements because they 

arise from, or are based on, conduct by the Released Parties. (See Doc. # 2324); see also

Musselman, 2013 WL 4496509, at *8.

First, none of the Love Providers’ claims in this MDL relate only to Non-Settling Love

Defendants’ “own[, separate] conduct.” Provider Plaintiffs allege that the Non-Settling Love

Defendants are liable for alleged participation in two purported nationwide conspiracies 

involving all Defendants and resulting in alleged unlawful agreements among all Defendants to 

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restrict competition: (1) the “Market Allocation Conspiracy” and (2) the “Price Fixing and 

Boycott Conspiracy.” (Conway, Case No. 2:12-cv-02532-RDP, Doc. # 457 at ¶¶ 1, 4, 8). They 

allege that both conspiracies were carried out through the conduct of all Defendants. (Id.). 

Second, the fact that the WellPoint and Capital final approval orders state that the class 

certification analysis under Rule 23 is satisfied “for purposes of settlement only ... solely with 

respect to [Released Parties]” does not affect this court’s interpretation of the broad release 

language from the Settlement Agreements. 

Finally, as to the question of whether the Notice to the classes fully explained the extent 

of the Releases, the court observes that the Capital and WellPoint settlement notices directed

potential class members to the settlement administrator’s website so they could review a full 

copy of the settlement agreement, which contained additional details about the settlement and 

released claims. Therefore, “all material facts were available to class members because a full 

copy of the settlement agreement, and the release, were available on a website referenced in the 

Notice.” Greco v. Ginn Dev. Co., LLC, 635 F. App’x 628, 634 (11th Cir. 2015).

As the Love Providers’ claims in this MDL are within the scope of the WellPoint and

Capital Settlement Agreement releases (as they arise from, or are based on, conduct by the 

Released Parties) they are foreclosed. (See Doc. # 2324 at 11-12); see also Musselman, 2013 WL 

4496509, at *8. 

B. The WellPoint and Capital Settlement Agreements Do Not Contain the 

BlueCard Exception

In the Blues Settlement Agreement, the first sentence of the release paragraph reads:

“[e]xcept for Claims for damages against defendants in the Action that are not Parties relating to 

providing Covered Services to Blue Plans' Plan Members in connection with the BlueCard 

Case 2:13-cv-20000-RDP Document 2902 Filed 02/16/22 Page 18 of 23
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Program and other similar national account delivery programs governed by BCBSA (including 

but not limited to NASCO-to-NASCO arrangements) ... .” (Doc. # 2221-4 at § 13.1(b)). This 

provision serves as a carve out from the release. But, the parties’ carve out is limited in scope. In 

addressing the Blues Settlement Agreement, Judge Torres explained that “[i]n order for Plaintiffs 

to benefit from the exception, the plain terms of that Agreement require that their claims must: 

“(1) be Claims for damages; (2) against Defendants in the Action that are not Parties; (3) relate 

to providing Covered Services to Blue Plans’ Plan Members; and (4) be in connection with the 

BlueCard Program and other national account delivery programs governed by BCBSA.” (Doc. # 

2221-12 at 8). Judge Moreno affirmed and adopted Judge Torres’s Report and Recommendation 

and its rationale related to the Blues Settlement Agreement. (Doc. # 2221-13 at 3).

Importantly, however, the WellPoint and Capital Settlement Agreements do not contain 

the “BlueCard Exception.” (Compare Doc. # 2221-6 at § 13.1 and Doc. # 2221-8 at § 9.1 with

Doc. # 2221-4 § 13.1(b)). Therefore, under the release provisions of the WellPoint and Capital

Settlement Agreements, there is no exception to save certain of the Love Providers’ damages 

claims. Certain Defendants’ Motion seeks summary judgment only under the WellPoint and 

Capital Settlement Agreements, and neither of those Agreements contains the BlueCard 

Exception. Therefore, the Love Providers’ damages claims, like their injunctive relief claim, are 

barred by the release provisions of the WellPoint and Capital Settlement Agreements, and there 

is no Blue Card Exception to save them.

C. Claim Preclusion Also Bars The Love Providers’ Claims

“[C]laim preclusion applies to class actions just the same as to other types of lawsuits.” 

Thomas v. Blue Cross & Blue Shield Ass’n, 333 F. App’x 414, 417 (11th Cir. 2009) (citing 

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Adams v. S. Farm Bureau Life Ins. Co., 493 F.3d 1276, 1289 (11th Cir. 2007)). “‘In order for 

claim preclusion to apply, four elements are required: (1) a final judgment on the merits; (2) 

rendered by a court of competent jurisdiction; (3) identity of the parties; (4) identity of the causes 

of action.’” Thomas, 333 F. App’x at 417 (quoting Adams, 493 F.3d at 1289). “‘Claim preclusion 

applies not only to the precise legal theory presented in the previous litigation, but to all legal 

theories and claims arising out of the same operative nucleus of fact.’” Id. (quoting Adams, 493 

F.3d at 1289).

“Where the parties consent to [] a dismissal based on a settlement agreement, [] the 

principles of res judicata apply (in a somewhat modified form) to the matters specified in the 

settlement agreement, rather than the original complaint.” Norfolk S. Corp. v. Chevron, U.S.A., 

Inc., 371 F.3d 1285, 1288 (11th Cir. 2004). In the settlement context, a court may “consider the 

parties’ settlement documents to determine the claims at issue in a prior action.” TVPX ARS, Inc. 

v. Genworth Life & Annuity Ins. Co., 959 F.3d 1318, 1326 (11th Cir. 2020) (citing Adams, 493 

F.3d at 1290-91). “The expressed intent of the parties is [] the determining factor in whether a 

consent-based judgment is given collateral estoppel effect.” Norfolk Southern, 371 F.3d at 1288 

(citing Balbirer v. Austin, 790 F.2d 1524, 1528 (11th Cir. 1986)). And “[t]he best evidence of 

that intent is, of course, the settlement agreement itself.” Id. at 1289.

In Thomas, the Eleventh Circuit considered the preclusive effect of the Blue Settlement 

Agreement from Love. 333 F. App’x at 416. Here, as in Thomas, the Love Providers do not 

appear to challenge the first three elements of claim preclusion. “It is clear that the Love action 

reached a final judgment on the merits, [and] that the United States District Court for the 

Southern District of Florida had jurisdiction ... .” Id. at 417. Moreover, according to the Conway

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Complaint, certain named Provider Plaintiffs were “Love Providers:” Charles H. Clark III, M.D., 

Robert W. Nesbitt, M.D., Luis R. Pernia, M.D., Corey Musselman, M.D., Julie McCormick, 

M.D., L.L.C., Harbir Makin, M.D., Hillside Family Medicine, LLC, Ear, Nose & Throat 

Consultants and Hearing Services, P.L.C., and Kathleen Cain, M.D. (Conway v. Blue Cross and 

Blue Shield of Alabama et al, Case No. 2:12-cv-02532-RDP, Doc. # 457 at ¶¶ 42, 559). 

Therefore, these Love Providers were parties to the Love action and WellPoint and Capital

Settlement Agreements for the purpose of claim preclusion. See Thomas, 333 F. App’x at 417.

And, “[a]s alleged co-conspirators, all Defendants in this case are in privity with [each other], 

thus meeting the element of identical parties for res judicata purposes.” Powell v. Gorham, 2013 

WL 3151632, at *10 (N.D. Ala. June 14, 2013) (collecting cases); see also Sheba Ethiopian 

Rest., Inc. v. DeKalb Cty., Georgia, 820 F. App’x 889, 898 (11th Cir. 2020) “[C]o-conspirators 

are considered to be in privity for purposes of res judicata.”). 

The Love Providers do dispute that the res judicata effect of the WellPoint and Capital 

Final Judgments extends to the claims at issue in this MDL. More specifically, they argue that

Defendants rely on a res judicata standard that does not apply in the settlement context. (Doc. # 

2799 at 24). But, that argument misses the mark. The court has set forth the correct standard 

above. That is, the determining factor in whether a consent-based judgment is given preclusive 

effect is “[t]he expressed intent of the parties,” the “best evidence” of which is “the settlement 

agreement itself.” Norfolk Southern, 371 F.3d at 1288-89.

Again, in the WellPoint Settlement Agreement, the Releasing parties agreed:

to forever abandon and discharge any and all Claims that exist now or that might 

arise in the future against BCBSA and/or any Blue Cross and/or Blue Shield 

licensee or wholly-owned subsidiary of such licensee, which Claims arise from, 

or are based on, conduct by any of the Released Parties that occurred on or 

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before the Effective Date and are, or could have been, alleged in the Complaints, 

whether any such Claim was or could have been asserted by any Releasing Party 

on its own behalf or on behalf of other Persons.

(Doc. # 2221-6 at 76 § 13.1(b)) (emphasis added). In the Capital Settlement Agreement, the 

Releasing parties agreed:

to forever abandon and discharge any and all Claims that exist now or that might 

arise in the future against any other persons or entities, which Claims arise from, 

or are based on, conduct by any of the Released Parties that occurred on or 

before the Effective Date and are, or could have been, alleged in the Complaints, 

whether any such Claim was or could have been asserted by any Releasing Party 

on its own behalf or on behalf of other Persons.

(Doc. # 2221-8 at 11 (§ 9.1(b)) (emphasis added). 

In this Circuit, “[i]f a case arises out of the same nucleus of operative facts, or is based 

upon the same factual predicate, as a former action, ... the two cases are really the same ‘claim’ 

or “cause of action” for purposes of res judicata.’” Baloco v. Drummond Co., 767 F.3d 1229, 

1247 (11th Cir. 2014) (quoting Griswold v. Cnty. of Hillsborough, 598 F.3d 1289, 1293 (11th 

Cir. 2010)). As Judge Moreno has already correctly held, the Musselman and Conway

Complaints are both “based on allegations that Defendants, acting through BCBSA, conspired to 

reduce provider reimbursement” and those parties “could have asserted these claims before Love

[were] settled.” Musselman, 2013 WL 4496509, at * 5. Although the claims in Love and in 

Conway were based on different causes of action, for purposes of claim preclusion they arose out 

of the same nucleus of operative facts. Therefore, all elements of claim preclusion are present 

here.

The Love Providers’ argument that it would violate class members’ due process rights to 

apply res judicata to their claims is also without merit. But, that simply is not so. Again, as noted 

above, “all material facts were available to class members because a full copy of the settlement 

Case 2:13-cv-20000-RDP Document 2902 Filed 02/16/22 Page 22 of 23
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agreement, and the release, were available on a website referenced in the Notice.” Greco v. Ginn 

Dev. Co., LLC, 635 F. App’x 628, 634.

IV. Conclusion 

For all the reasons discussed above, Certain Defendants are entitled to summary 

judgment on the claims asserted by the Love Providers is due to be granted.

A separate order will be entered in this MDL, and in Conway v. Blue Cross and Blue 

Shield of Alabama et al, Case No. 2:12-cv-02532-RDP.

DONE and ORDERED this February 16, 2022.

_________________________________

R. DAVID PROCTOR

UNITED STATES DISTRICT JUDGE

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