Kartell v. Blue Shield of Massachusetts, Inc.
United States Court of Appeals for the First Circuit
749 F.2d 922 (1984)
Blue Shield of Massachusetts (Blue Shield) (defendant) directly paid physicians for medical treatment rendered to individual subscribers of its Blue Shield health insurance plan. In order to receive payment, the physicians were required to sign a standard agreement promising to accept the Blue Shield payment in full and not to separately charge patients for services. The patient paid nothing out of pocket. Virtually all Massachusetts physicians participated in the Blue Shield program and Blue Shield covered nearly 74% of all privately insured Massachusetts residents. Kartell (plaintiff) and several other Massachusetts physicians brought suit against Blue Shield claiming the requirement to not separately charge patients, also known as a “ban on balance billing”, violated § 1 of the Sherman Act (prohibition against agreements restraining trade) and § 2 of the Sherman Act (prohibition against agreements creating monopolization). The district court found that Blue Shield’s practice violated § 1 of the Sherman Act because Blue Shield’s payment-in-full requirement interfered with the physicians’ freedom to set higher prices for more expensive services. Blue Shield appealed.
Rule of Law
Holding and Reasoning (Breyer, J.)
What to do next…
Unlock this case brief with a free (no-commitment) trial membership of Quimbee.
You’ll be in good company: Quimbee is one of the most widely used and trusted sites for law students, serving more than 97,000 law students since 2011. Some law schools—such as Yale, Vanderbilt, Berkeley, and the University of Illinois—even subscribe directly to Quimbee for all their law students. Read our student testimonials.
Learn more about Quimbee’s unique (and proven) approach to achieving great grades at law school.
Quimbee is a company hell-bent on one thing: helping you get an “A” in every course you take in law school, so you can graduate at the top of your class and get a high-paying law job. We’re not just a study aid for law students; we’re the study aid for law students. Read more about Quimbee.
Here's why 168,000 law students have relied on our case briefs:
- Written by law professors and practitioners, not other law students. 13,800 briefs, keyed to 187 casebooks. Top-notch customer support.
- The right amount of information, includes the facts, issues, rule of law, holding and reasoning, and any concurrences and dissents.
- Access in your classes, works on your mobile and tablet. Massive library of related video lessons and high quality multiple-choice questions.
- Easy to use, uniform format for every case brief. Written in plain English, not in legalese. Our briefs summarize and simplify; they don’t just repeat the court’s language.