Abstract

In Singh v. Blue Cross/Blue Shield of Massachusetts, Inc., the U.S. Court of Appeals for the First Circuit held that defendant Blue Cross/Blue Shield's peer review practices satisfied the immunity standard for professional review actions according to the Health Care Quality Improvement Act, and the First Circuit affirmed the U.S. District Court for the District of Massachusetts's grant of summary judgment in favor of the defendant.After Blue Cross/Blue Shield merged with Bay State Health Care, Blue Cross began to offer “Bay State Health Care” to former Bay State subscribers. Blue Cross denied the plaintiff, Dr. Kunwar Singh, participation in the Bay State Healthcare Network due to poor utilization review. Singh sought reconsideration, and Blue Cross agreed to audit his practices before making a final decision.