All told, Michigan neighborhoods lost 192 Rite Aid pharmacies. The US lost over 2000, largely due to DOJ prosecution under the False Claims Act and Controlled Substances Act.

Yet no court made a determination of fault. It all ended with a settlement.

Court Docket's summary is thoroughly footnoted and well worth the read. Footnote numbers elided for clarity in this clip.

https://courtdocket.org/rite-aid-lawsuit-settlements-opioids-data-breach-bankruptcy/

By October 2023, Rite Aid had lost more than $1 billion in the preceding months and was carrying nearly $4 billion in debt, much of it tied to opioid litigation. The first Chapter 11 filing came on October 16, 2023. Rite Aid emerged in late August 2024 as a private company owned by its lenders, still carrying $2.5 billion in liabilities.

The reorganization did not hold. New Rite Aid, LLC filed a second Chapter 11 in the District of New Jersey on May 5, 2025 (Case No. 25-14861), structured as an orderly wind-down.19 Pharmacy assets from more than 1,000 stores were sold to CVS, Walgreens, Albertsons, Kroger, and Giant Eagle. By October 2025 every store had closed. The court confirmed the Joint Plan of Reorganization on November 26, 2025, with an effective date of December 31, 2025, and closed the cases for 117 affiliated debtors on December 30, 2025.

The practical effect: money owed by Rite Aid itself, including the data breach settlement fund, sits inside a liquidating estate. The DOJ’s $401.8 million claim is a general unsecured claim in that estate, meaning the government stands in line with other creditors rather than collecting the face value in cash. Recoveries against Walgreens under the Chabot case were unaffected, because that money came from Walgreens, not Rite Aid. If you have a live claim tied to Rite Aid directly, check the case-specific settlement site or the Kroll restructuring portal for updated distribution timing.

So individual claimants and third-party payors, most prominently Medicare and Medicaid, were paid something. The DOJ settlement statement:
https://www.justice.gov/archives/opa/pr/rite-aid-corporation-and-affiliates-agree-settle-false-claims-act-and-controlled-substance

The final result

Americans' pharmacy options contracted. Medication prices continue to rise. The PBM middlemen that caused some of Rite Aid's financial woes continue to thrive. 

And now DOJ has announced a CVS settlement under the same federal laws.
https://mihealthfreedom.org/community/following-pharma/deja-vu-cvs-to-pay-millions-in-doj-false-claims-opioid-settlement/#post-3383

Ultimately, we need to ask ourselves whether sacrificing individual responsibility in purchasing, in exchange for government redistribution schemes, is true justice. Are the end results worth the cost?

https://mihealthfreedom.org/community/industry-influence-on-state-health-policy-2/rite-aid-going-bust-again/

Americans' pharmacy options shrank. Medication prices continue to rise. The PBM middlemen that helped cause Rite Aid's financial woes are thriving. 

And now DOJ announces a CVS settlement under the same federal laws. Michigan has 253 CVS store locations spread across 113 cities.

Ultimately, we need to ask ourselves whether sacrificing individual responsibility in purchasing, in exchange for government control and redistribution schemes, is true justice. Are the end results worth the cost?

So, here we go again. 

The DOJ press release re CVS has hotlinks at the original site.

https://www.justice.gov/opa/pr/cvs-agrees-pay-315m-illegally-filling-unlawful-opioid-prescriptions-and-submitting-false

CVS Agrees to Pay $315M for Illegally Filling Unlawful Opioid Prescriptions and for Submitting False Claims to the Federal Government

Tuesday, October 13, 2026

For Immediate Release

Office of Public Affairs

CVS Pharmacy Inc., a Rhode Island-based pharmacy chain, and its related corporate entities (collectively, CVS) have agreed to pay $315 million to resolve allegations that, from October 17, 2013 through December 2, 2025, CVS illegally filled prescriptions for opioids and other controlled substances in violation of the Controlled Substances Act (CSA), and then sought payment for many of those invalid prescriptions from Medicare and other federal healthcare programs in violation of the False Claims Act (FCA).

“Not only does this settlement hold bad actors accountable for their fraudulent activities, but Americans are safer because of it,” said Associate Attorney General Stanley E. Woodward Jr. “Today’s settlement is a significant milestone in the Justice Department’s efforts to combat the opioid epidemic by cracking down on pharmacies who unlawfully fulfill prescriptions for controlled substances.”

“Today’s settlement requires CVS to implement additional safeguards to ensure that prescriptions for opioids and other controlled substances are dispensed only when medically appropriate,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “The remedial measures in this agreement — including proactive monitoring of opioid prescribing patterns — will provide critical protections for patients and federal healthcare programs. The Department of Justice will continue to take steps to prevent the unlawful dispensing of opioids.”

“The opioid epidemic has affected families and communities across Rhode Island and throughout the nation,” said First Assistant U.S. Attorney Charles C. Calenda for the District of Rhode Island. “Pharmacies that dispense controlled substances must maintain effective compliance systems to identify and respond to warning signs that prescriptions may be unlawful or medically unnecessary. This settlement demonstrates the importance of those obligations and the consequences of failing to implement safeguards designed to prevent the improper dispensing of controlled substances.”

The settlement resolves allegations in the government’s complaint, which the United States filed on Dec. 13, 2024, in the U.S. District Court for the District of Rhode Island, that CVS knowingly filled prescriptions for controlled substances that lacked a legitimate medical purpose, were not valid, and/or were not issued in the usual course of professional practice. The United States alleged that CVS dispensed prescriptions for dangerous and excessive quantities of opioids, opioid prescriptions filled too early, and “trinity” prescriptions, a dangerous and abused combination of an opioid, a benzodiazepine, and a muscle relaxant. CVS also allegedly filled prescriptions for controlled substances from “pill mill” prescribers who issued large numbers of controlled substance prescriptions without any medical purpose. Further, the United States alleged that CVS pharmacists filled these prescriptions despite clear red flags indicating that there was a high likelihood that the prescriptions lacked a legitimate medical purpose, were not valid, or were not issued in the course of professional practice. Many of these prescriptions were ultimately billed to and reimbursed by federal healthcare programs.

The complaint further alleged that CVS’s violations stemmed from corporate-imposed performance metrics, incentive compensation, and staffing policies that prioritized corporate profits over patient safety. CVS failed to employ enough pharmacists to serve patients, comply with CVS’s legal obligations, and meet corporate performance metrics. In addition, CVS’s policies allegedly prevented pharmacists from warning one another about certain problematic prescribers.

In addition to the monetary payment announced today, CVS has entered into a memorandum of agreement with DEA to address its future obligations in dispensing controlled substances. This agreement requires CVS to establish a hotline for both employees and the public to report suspected illegal dispensing of controlled substances, proactively monitor the dispensing patterns of its pharmacies to identify and address potentially illegal dispensing, and establish a process to evaluate prescribers suspected of illegal prescribing.

“This settlement agreement highlights DEA’s commitment to protecting the health and safety of Americans while holding CVS accountable for dispensing unlawful prescriptions and endangering the public,” said DEA Assistant Administrator Cheri Oz. “DEA is unwavering in its commitment to protect public health and ensuring pharmacies adhere to the highest standards of responsible dispensing. We will continue to work closely with law enforcement, regulatory agencies, and the healthcare community to prevent the misuse of controlled substances, and we will hold those who jeopardize the safety of our citizens accountable.”

“Behind every unlawful prescription is a patient who could be put in harm’s way,” said Acting Deputy Inspector General for Investigations Miranda L. Bennett of the U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG). “The allegations in this case point to warning signs that should never be overlooked. HHS OIG will not tolerate conduct that jeopardizes lives, and we will continue to pursue those who betray the trust placed in them.”

The civil settlement resolves a civil lawsuit filed by Hillary Estright, a former CVS employee, under the whistleblower provision of the FCA, which authorizes private parties to sue on behalf of the United States and receive a share of any recovery. It also permits the United States to intervene and take over such lawsuits, as it did here. The amount to be recovered by the private whistleblower has not yet been determined. The qui tam case is captioned United States ex rel. Hillary Estright v. CVS Health Corporation, et al., No. 22-cv-00222 (D.R.I.).

This year the Administration launched the Task Force to Eliminate Fraud and the National Fraud Enforcement Division to enhance the Administration’s war on fraud, waste, and abuse in federal programs. When unscrupulous actors exploit these programs for their own financial gain, they defraud the government, harm the people these programs are designed to aid and protect, and undermine American businesses that play by the rules. The Civil Division’s FCA enforcement plays a critical role in combatting such fraudulent schemes, recovering billions of dollars for the American taxpayers, and holding wrongdoers accountable. FCA matters will continue to be on the forefront of the battle against fraud, and the Civil Division’s FCA work will support and advance the mission of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the Enforcement & Affirmative Litigation Branch, along with the U.S. Attorneys’ Offices for the District of Rhode Island, Eastern District of Virginia, Eastern District of Texas, and District of Hawaii. The DEA’s Office of Diversion Control, Los Angeles Field Division, Richmond District Office, and Office of Chief Counsel led this case with substantial assistance from Health and Human Services Office of Inspector General, Defense Criminal Investigative Service, Defense Health Agency (DHA), Office of Personnel Management (OPM), Department of Labor (DOL) Office of Inspector General, and the Department of Veterans Affairs (VA).

The investigation and resolution of this matter illustrate the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The United States is represented in this matter by attorneys from the Justice Department’s Civil Division Commercial Litigation Branch, Fraud Section (Assistant Director Natalie Waites and Trial Attorneys Claire Norsetter and Megan Engel) and Enforcement & Affirmative Litigation Branch (Deputy Director Lisa Hsiao and Trial Attorneys Kathleen Brunson and Katherine Ho), as well as from the U.S. Attorneys’ Offices for the District of Rhode Island (Assistant U.S. Attorney Rachna Vyas), Eastern District of Virginia (Assistant U.S. Attorney John Beerbower), Eastern District of Texas (Assistant U.S. Attorney James Gillingham), and District of Hawaii (Assistant U.S. Attorney Tracy J. Weinstein).

The claims resolved by the settlement are allegations only and there has been no determination of liability.

Note: Find the CSA agreement here and the FCA agreement here.

Note: This press release has been updated from a previous version.

Updated October 14, 2026

AMAC sounds off on Medicare for All in this week's opinion piece.

https://amac.us/newsline/medicare-for-nobody

Medicare for Nobody

Medicare for All could bankrupt Medicare in just 2-3 years, putting seniors' hard-earned health coverage at risk. Here's what retirees need to know.

Stephen Moore     |    October 13, 2026

Political pros will remember that a dozen or so years ago, the Democrats produced a famous (or infamous) TV ad showing a man wheeling an elderly lady in a wheelchair up a path to an overlook on a mountain. At the end of the ad, the man pushes the woman out of her chair and off the cliff.

The person pushing the wheelchair was a lookalike of Paul Ryan, the then-Republican speaker of the House. The idea of the ad was that congressional Republicans had a secret plan to take away Medicare from elderly Americans dependent on the program.

There was never any such doomsday plan, just a series of common-sense steps to control program costs.

But ironically enough, now there really is a plan to bankrupt Medicare and put millions of American senior citizens at risk of losing their health coverage.

It's called Medicare for All, and the idea of the scheme is to offer free health care for everyone in the country.

The bill to create Medicare for All has a multitrillion-dollar price tag. Medicare is already scheduled to run out of funds in about seven years; this Medicare for All plan ensures the program runs out of money in two to three years. Wonderful news.

Vermont Sen. Bernie Sanders is the lead sponsor of the Medicare for All bill, and he already has 18 cosponsors.

Meanwhile, most of the democratic socialists who have seemingly taken command of the Democratic Party in the last few months are almost all fully on board this train that is picking up momentum on the campaign trails.

Free health care! Who could be against that?

Well, seniors, for one. The folks on Medicare are dependent on the coverage,

And they paid dutifully for many years into the trust fund via the 3.8% payroll tax when they were working.

We would expect that Democrats would be sprinting away from Medicare for All at full speed. Instead, many are hopping on this train.

It is by far the most expensive feature of the democratic socialist policy agenda. The Trump White House puts the price tag at well over $50 trillion. In other words, Democrats are providing more health benefits and more free stuff to buy votes.

But the financial reality is no secret to seniors. They strongly oppose expanding their gold-plated coverage plan to people who are young or unemployed and haven't paid for any of the benefits.

I call the Democratic scheme the "throw grandma from the train" scenario.

The program will run out of money. Medicare coverage will be severely trimmed. The plan will eventually blow up.

You might even say that now Dem congressional leaders Sen. Chuck Schumer and Rep. Hakeem Jeffries are the ones with plans to parade seniors up that hill only to toss them off.

What's further infuriating is, the Sanders Medicare for All scheme would make even illegal immigrants eligible for free health care. The law as written would apply to any "resident" of the U.S. -- which will only further encourage illegal entries.

Obviously, all these expansions will put Medicare into a financial freefall.

Medicare for All will morph into Medicare for Nobody. Seniors need to make it clear that the plan that Bernie envisions will lead to rationing of heath care along with worsening coverage and medical outcomes.

What a deal.

Kudos to these students, Forest Hills, Ferris State, and the Center for Medical Training for taking hold where it counts!

NOTE: The term "medical certification" is erroneous. CNA stands for Certified Nurse Aide, as defined in Michigan law and registry.

Medicine has its own separate degree structure.

https://www.woodtv.com/news/kent-county/forest-hills-central-students-earn-medical-certification/

Forest Hills Central students earn medical certification

Teresa Weakley    |    Oct 9, 2026

ADA TOWNSHIP, Mich. (WOOD) — On a Friday afternoon at Forest Hills Central High School, students aren’t just reading about patient care. They’re practicing it.

Inside a classroom set up more like a healthcare lab than a typical high school course, students learn hands-on skills they’ll soon use in real healthcare settings.

Through a new partnership involving the Center for Medical Training and Ferris State University, students can earn college credit while working toward certification as a nursing assistant before they graduate.

“It’s like to practice it so that we can then perform it when we go and visit hospitals,” senior Maisey Pell said.

The program debuted at Forest Hills Central this school year. Students complete online coursework connected to Ferris State while spending Fridays in hands-on training sessions at their own school. There, they practice skills under the guidance of healthcare professionals before moving into clinical settings.

“We were doing skills checkoffs,” Ashley Bauer, founder and director of the Center for Medical Training, said. “Each week we learn a new skill. The students come in and then they will perform that skill.”

After completing those checkoffs, students head into nursing homes and healthcare facilities to work with actual patients under supervision.

“After they get done with their clinical check-offs, then we take them into a nursing home or a healthcare facility, where they then perform the skills on actual patients,” Bauer said.

The goal is for students to take Michigan’s nurse aide exam before the semester ends and become certified nursing assistants, or CNAs.

“Hopefully I’ll have the certification to be a nursing assistant at least. Then I can hopefully go into college with that and have the background to pursue nursing,” Pell said.

For her, the program offers something traditional classes can’t.

“We get to come and do some more hands-on learning,” Pell said. “With the professors, it’s lectures and stuff, which is very helpful. But this is a little bit more helpful because then we can actually do stuff.”

The program grew out of Bauer’s 20-year healthcare career. She started as a CNA herself, later becoming a licensed practical nurse and then a registered nurse.

During the COVID-19 pandemic, she watched staffing shortages strain healthcare systems and began looking for ways to build a larger pipeline of future workers.

“I worked in healthcare for 20 years, and through COVID I was like, ‘Man, we really need help. How can we get more help?'” Bauer said. “How can we build more interest in this?”

The Center for Medical Training, based in Grandville, provides state-certified nurse aide training focused on hands-on learning and career preparation. Now entering its third year, the organization works with multiple school districts and customizes programs to meet each school’s needs.

“This was the first year that we stepped out of our own classroom and stepped into somebody else’s building. It’s been so much fun,” Bauer said.

The model appears to be working. During a recent tour of a local healthcare facility, Bauer’s students were greeted by two graduates of the program who are already working in the field.

“It was awesome to see two of our previous students meet us at the door,” she said. “To see them be successful too.”

The experience also gives students a chance to test-drive a career before investing years and thousands of dollars in college.

“This is also experience to see if we really want to go into nursing. I think it’s totally helpful since we’re still in high school,” Pell explained.

For students who discover healthcare isn’t the right fit, Bauer considers that a success too.

“Some students recognize through this, like, ‘Maybe healthcare is not my thing,'” she said.

As for Pell, she’s still committed to nursing, even if she’s a little nervous about the next step.

“I would say I’m a little nervous to go and do it on an actual resident and perform the skills,” she said. “But with all the training and practice that we have here, hopefully I’ll be able to do that and be successful.”

Bauer hopes more schools will eventually join the program.

“We would love to see this expand to several different schools. We’re really getting these students ready,” she said.

This trenchant quote sets the stage for MDHHS's Oct 13 Maternal Infant Health Update, below.

The receipts and more from Delano Squires discussing his recent book The Vanishing Black Family in Thursday's Hillsdale Podcast. https://podcast.hillsdale.edu/the-vanishing-black-family/

When The System Becomes the Barrier: Transforming a Patient’s Experience into Healthcare System Change

“If the patient encountered the same problem at multiple points within the healthcare system, we must examine the system—not only the individual.”
—Mary Dixon‑Woods

Patient experience is an important indicator of healthcare quality, yet experiences of stigma, discrimination, disrespect, and poor communication are often addressed as isolated interpersonal events rather than potential indicators of system level problems. This article examines how a patients experience involving a young, Black, pregnant woman living with HIV can serve as a catalyst for healthcare-system improvement. When concerns occur at multiple points across a patient’s healthcare journey, healthcare leaders and clinicians should examine organizational processes, communication, care coordination, policies, culture and accountability in addition to individual behavior.

The Patient Experience: A Case That Reveals System Failure
Background Summary: J.S. is a 32-year-old HIV positive pregnant woman who moved to the US from Somalia 5 years ago. When J.S. arrived in the U.S she was about 7 months pregnant and had not received any prenatal care. J.S. had a spontaneous delivery on December 25, 2023. The infant was born with severe medical complications. It was later determined the infant was HIV positive with advanced AIDS.

Fast forward two years later, J.S. is in and out of HIV care, returns to the Ryan White agency pregnant, and seeks assistance for medical care and resources. The Ryan White agency re-engages the client in medical care and helps her navigate her OB, ID, and other medical needs while addressing her social needs. Ultimately, the patient maintains viral load suppression and a plan in place to deliver her baby vaginally

Through complex social determinants and life circumstances. J.S. pushed through to maintain viral load suppression and have a non-complicated vaginal delivery and an HIV-negative infant. After delivery, the following events occurred throughout her postpartum stay on a labor and delivery unit.

The following account is not simply a report of poor bedside manners—its details signal broad structural issues:

Delayed discharge four days after a vaginal delivery
No nutritious meal offered after labor and delivery
No welcome/gift bag or infant discharge teaching
No infant medication administration education
A nurse questioning the authenticity of a new, in‑box car seat
Missed long‑acting ART dose due to poor coordination during the hospital stay
These failures highlight critical gaps in:

Care coordination between obstetrics and HIV providers
Respect, dignity, and equitable treatment
Maternal and infant discharge processes
Communication and patient education
Organizational culture and accountability
Why This Case Matters: Maternal Health and HIV Care Are Intertwined
This is more than a patient complaint—it is a structural failure that directly implicates maternal and infant health. Stigma, inequitable treatment, inadequate discharge processes, and fragmented care coordination erode trust and create downstream consequences:

Avoidance of care
Missed appointments
Reduced engagement in HIV treatment
Delayed symptom reporting
Compromised maternal and infant outcomes
Her experience illustrates how disrespect, disorganization, and bias can silently undermine both maternal and HIV care.

In a state where dozens of maternal deaths occur annually- and where maternal mortality review committees consistently find preventable causes—experiences like hers must be treated as critical data points showing us where change is urgently needed.

From Patients Story to Systems Change: A Call to Action
A call to action for Ryan White Providers, Obstetricians, Infectious Disease Specialists, and Healthcare Leaders

We cannot allow this experience to be dismissed as unfortunate or uncommon. It is symptomatic of larger failures identified in statewide maternal mortality reviews. Addressing this case is not optional—it is part of our responsibility to ensure equitable, safe, patient -centered care for pregnant women and women living with HIV.

The United States Department of Health and Human Services and The Centers of Medicaid have outlined evidence-based strategies to reduce morbidities in healthcare systems, hospitals and birthing facilities to transform the maternal health model. One health system at a time, one pillar at a time and the time is now. Small changes create meaningful differences. But systemic accountability creates lasting transformation. If your health system is interested in learning more about stigma women with HIV face during prenatal care, delivery, infant feeding, and post-partum, please contact Sabrina Sanders.

Sabrina Sanders MSN,BSN,RN
HIV Clinical Nurse Consultant
Michigan Department of Health and Human Services
Cell: 517-275-2017
SandersS13@michigan.gov

Sabrina would be happy to provide opportunities for educational information.

Mother Infant Health Collaborative Meetings
Graphic that looks like triangle people in many different shades of blue
All meetings are virtual and scheduled from 1-3 p.m.

2026 MIHC meetings:

Nov.12.
2027 MIHC meetings:

Feb.11.
May 13.
Aug.12.
Nov. 4.
Registration is available on the Division of Maternal and Infant Health website.

Triangle People Graphic
For more information on maternal and infant health in Michigan visit:
Michigan.gov/MIH
Contact the Division of Maternal & Infant Health at MDHHS

Delano Squires is Director of the Center for Human Flourishing at The Heritage Foundation, focusing on the impact of marriage and family structure on social outcomes. He has written extensively on topics related to faith, family, and culture.

He earned a Bachelor of Science in Computer Engineering from the University of Pittsburgh, and his Master of Public Policy from George Washington University. He worked for over a decade in the District of Columbia government, and founded Civitas Consulting Group to assist organizations in creating opportunities for community prosperity.

How Welfare and Feminism Made Marriage Optional and Children Vulnerable comes from Penguin Press and wherever books are sold.

https://www.penguinrandomhouse.com/books/763688/the-vanishing-black-family-by-delano-squires/

Previous works are published in The Root, Newsweek, National Review, The American Conservative, The Federalist, Blaze Media, and The Institute for Family Studies. 

So what can we expect to change with this lawsuit? 

The 116-page court filing: https://www.michigan.gov/ag/-/media/Project/Websites/AG/releases/2026/October/State-BCBS-Complaint.pdf

CBS Detroit reported the original filing and initial BCBS response.

https://www.cbsnews.com/detroit/news/nessel-sues-blue-cross-blue-shield-michigan-health-insurance-monopoly/

Michigan AG sues Blue Cross Blue Shield of Michigan, accusing insurer of illegal monopoly

Paula Wethington    |    October 9, 2026 

Michigan Attorney General Dana Nessel said she has filed a federal lawsuit against Blue Cross Blue Shield of Michigan, accusing the company of illegally operating a health insurance monopoly in the state.

The case was filed Thursday in U.S. District Court for the Eastern District of Michigan. It seeks civil penalties, restitution and other financial relief as the court considers appropriate, as well as findings that the company violated the Sherman Act and the Michigan Antitrust Reform Act.

Blue Cross Blue Shield of Michigan controls 65% of the market for health insurance products in Michigan, and 79% of PPO insurance plans, the attorney general said. Her office argues that this market dominance "was obtained by a series of illegal and anti-competitive agreements in conspiracy with the entire Blue Cross Blue Shield network to allocate customers and territories, to restrict product offerings, and to eliminate competition for health insurance services."

She said that has raised health care costs for both businesses and consumers.

She also said medical professionals have "been forced to reduce services, replace medical staff with administrative positions, or exit the Michigan market entirely." Her office cited the closure of Sturgis Hospital, in St. Joseph County near the Michigan-Indiana state line, as an example. Sturgis Hospital closed in June, citing inadequate reimbursement for rural health care services.

Information the attorney general's office provided to support its claims includes:

More than 40% of Michigan small-business owners say rising health care costs are a financial burden.
More than 68% of Michigan adults surveyed in 2025 reported at least one instance in which they were forced to skip or delay medical care due to potential costs.
Michigan ranks 20th in the nation for the number of people with medical debt in collections.
With health insurance plans so closely linked to employment, Michigan families often don't have a choice of insurance provider, her office argued. Premiums for 2026 rose 23% to 24% for individual plan members and 11.2% for small group markets, the lawsuit said.

The litigation also references a contract dispute earlier this year between Michigan Medicine and Blue Cross Blue Shield of Michigan. A tentative agreement was reached in late May, only weeks before the end of the previous agreement on which care would be considered "in network" with lower out-of-pocket costs to customers.

In response to the lawsuit, Blue Cross Blue Shield of Michigan said in a statement, "We were blindsided by this announcement by the Attorney General." The company said it has not yet been served and can't comment on the case's merits, but it "fundamentally" disagrees with Nessel's description of an uncompetitive market.

"Competition exists everywhere in our state's insurance markets, with strong local and national insurers competing with us every day," the statement said. The company added that it has provided coverage in every county for nearly 90 years.

Crain's Grand Rapids has gone behind paywall, so this initial post is a bit of a tease. Background next.

https://www.crainsgrandrapids.com/health-care/cgr-blue-cross-michigan-lawsuit-20261013/

Michigan's anti-trust lawsuit against Blue Cross echoes a different costly national case

Dustin Walsh    |    October 15, 2026

Michigan Attorney General Dana Nessel is striking at healthcare affordability with a lawsuit against Blue Cross Blue Shield of Michigan.

The 116-page complaint, brought in U.S. District Court in Detroit last week, alleges Detroit-based Blue Cross conspired with affiliated insurers nationwide to divide geographic markets and restrict competition for major customers, including the state of Michigan. It claims other Blues plans refused to bid whenever the state sought proposals to administer the employee health plan, leading the state to overpay for years through duplicate and defective claims payments, undisclosed “savings” fees, and withheld rebates.

Nessel’s case follows a similar strategy to a decade-old national lawsuit against the Blue Cross Blue Shield Association, which resulted in multi-billion-dollar settlements. The association and its subordinate organizations maintained no wrongdoing despite the settlements and stated that it is common practice for licensees not to compete in the national lawsuit....

Speedy, low-cost options include meds, labs, radiology, primary care, coverage alternatives, and surgery.

Did I miss anything?

Citizens Council for Health Freedom hot-links cash pay healthcare sites in its two-page graphic download.

https://www.cchfreedom.org/wp-content/uploads/2026/09/CASH-PAY-RESOURCES-FINAL.pdf

Direct Primary Care connects you to the low-cost world.

Accept no substitutes - MHF did the deep dive for you.

Find hotlinks in the original post.

https://mihealthfreedom.org/direct-primary-care/

What is Direct Primary Care?

Abigail Nobel   |   Feb 23, 2022  Updated Oct 15, 2024

Direct Primary Care (DPC) is an affordable model of self-pay care that increasingly appeals to both patients and physicians. DPC fits well with health sharing membership and good medication shopping skills to provide maximum healthcare savings.

By definition, DPC should exclude insurance and associated headaches. This model achieves an outstanding array of healthcare freedom benefits for both the patient and the physician. True DPC will:

• return relationship and autonomy to the center of care
• eliminate cookie-cutter protocols, mandates, and formularies
• save money
• reduce complexity
• prioritize more time for care
• offer more office services
• eliminate reimbursement incentives
• individualize care
• no third party billing, coding, prior auth, or copays

Direct Primary Care works like a membership

Patients save time, money, and frustration. They sign up for monthly payments in the $50-$85 range, or pay a reduced annual rate. Most can expect to get into the office within a day or two. Visits are about care, not payment. Often included in the price: common labs, medications, minor procedures, and text or video access. Some add family members at a reduced rate.

On the other hand, physicians retake control of their professional autonomy and their schedule. A major benefit is getting to spend evenings with family instead of clicking boxes on electronic records.

Primary care practices are the most common DPC adopters, but Urology, Dermatology, Podiatry, and other specialties also enjoy the freedom of this model.

How do I find a DPC Practice in Michigan?

DPC maps are the Wild West, with all sorts of innovators trying to capture the market. Both of these free market leaders are worth checking out: The Wedge of Health Freedom, and the DPC Frontier Mapper.

In addition, new practices are constantly starting up. To be sure you don’t miss out, search your nearest city + Direct Primary Care and DPC.

Share this article and grow the conversation. Ask around for DPC recommendations, and give your own. What does DPC quality mean to you and your doctor?

Final tips:

DPC is attracting major employers, cities, counties, and other government units. Their DPC-like arrangements will save costs for employee healthcare benefits.

However, be alert: in the end, third party involvement always costs patients and physicians in lost autonomy.

Direct Primary Care practices are unique and vary widely. Shop well, and don’t be afraid to ask offices for all the information you need to find the best fit!

Bill text here: https://www.rickscott.senate.gov/services/files/A825A3CA-ADE1-4E2D-8F5D-7E98D65BA27A

Two of the sponsors co-write a Washington Examiner op-ed describing the proposal.
https://www.washingtonexaminer.com/restoring-america/faith-freedom-self-reliance/3916505/healthcare-crisis-congress-more-affordable-care-act/

The article, clipped here for length, points out that people -

... cannot compare prices between providers before making decisions about their own health. They have fewer hospital and physician choices, and they watch helplessly as subsidies flow to insurance companies while their out-of-pocket costs keep rising. These aren’t partisan complaints. This is the experience of millions of Americans across the political spectrum.

Our approach is straightforward: stop treating families like statistics and start treating them like the capable decision-makers they are. Instead of funneling billions of taxpayer dollars through layers of bureaucracy to large insurance companies, redirect those resources into Trump Health Freedom Accounts, where individuals have control over their healthcare dollars. Families can use these funds to pay premiums or other healthcare expenses, while also having the flexibility to shop for insurance across state lines to compare multiple plans and choose coverage that truly meets their needs.

The difference is profound. Rather than being forced to accept whatever narrow physician and hospital network Washington or an insurance company offers, families will have real, affordable options. They can seek out the specialist three states over who has the best track record treating their condition. They can weigh whether a high-deductible plan with lower premiums makes more sense for their situation. They make informed choices that reflect the realities of their lives, not the preferences of distant policymakers. It’s no accident that this solution comes from leaders representing Texas and Florida, two states that have consistently shown that less government interference and more market freedom deliver better results for families.

Our bill maintains all protections for Americans with preexisting conditions, a commitment we make without caveat or exception. It also gives states the flexibility to expand narrow markets by waiving certain federal mandates that have restricted competition and driven up costs.

Perhaps the most transformative element is transparency. Right now, American healthcare operates in a pricing black box. Families receive more information about the cost of a used car than a CT scan. We change that by requiring hospitals to disclose actual prices — not estimates, not ranges, but the real costs patients will face. Additionally, this legislation mandates public reporting of outcomes data so Americans can compare not just prices, but quality and success rates across providers.

Imagine seeing upfront what a procedure will cost, then comparing that price and the provider’s track record with other hospitals in your region or across the country. This is standard practice in virtually every other consumer market. There is no reason healthcare should remain the exception.

And now is the time to act. Republicans control both chambers of Congress and the White House. If meaningful reform cannot happen now, with a unified government and clear public demand for change, when can it? The people didn’t grant us this majority to conduct more studies. They expect solutions to problems that have festered for more than a decade.

ASSOCIATION HEALTH PLANS CAN FIX THE SMALL BUSINESS HEALTHCARE CRISIS

Our proposal provides the people with solutions to the core complaints Americans have about their healthcare: costs, choice, and transparency. It is a proposal that maintains the exchanges, protects coverage for preexisting conditions, and supports working people. At the same time, it radically transfers power away from Washington and into the hands of patients by allowing you to keep the money you earn, shop for the care that fits your needs, and know the true cost of the treatments you’re considering. This isn’t ideological warfare; it’s common sense.

It’s time for Congress to stop talking about addressing the failures within our healthcare system and start voting on it. The More Affordable Care Act is on the table. The people are watching. It’s time for us to act.

August Pfluger represents Texas’s 11th Congressional District in the U.S. House of Representatives. Rick Scott is the senior U.S. senator from Florida.

Lanhee Joseph Chen is an American political scientist, lawyer, legal scholar, and academic who serves as the David and Diane Steffy Fellow in American Public Policy Studies and Co-Chair of the Health Care Policy Working Group at the Hoover Institution. He is also director of domestic policy studies and a lecturer in public policy at Stanford University.

His 2023 open access article on JAMA Health Forum explains 1115 waiver shortcomings.

https://jamanetwork.com/journals/jama-health-forum/fullarticle/2805043

The aim of the Healthy Indiana Plan was to create incentives for participants to think about their own health care consumption, as well as to promote saving and personal ownership of the accounts. Nevertheless, the Healthy Indiana Plan includes many complex rules that restrict the use of the savings accounts. Participants never fully own their account balance. And only their contributions (and not money from the state) can be returned to them if they leave the program in good standing. These policies reduce incentives to be price conscious and fail to give recipients more control over their health care.

Pairing HSAs with Medicaid would maintain health coverage, but unlike standard Medicaid, would give beneficiaries an asset that offers value beyond traditional Medicaid coverage. The accounts would offer them more choice in the health care they consume and the potential for greater financial security in the long run.

Currently, federal rules force most Medicaid recipients into coverage without major options. This contrasts with the expansion of private coverage options, particularly after the pandemic. Recent expansions in Direct Primary Care and consumer-directed health arrangements, for example, have given those with job-based coverage more choices. Changes to existing waiver rules would allow innovations from private coverage to potentially extend to Medicaid beneficiaries as well.

Medicaid recipients should have more of the same choices that individuals in private coverage have, and states are well positioned to offer it.

He points out, interestingly, that ACA Section 1332 waivers may offer a better path out of Medicaid dependency.

https://www.cms.gov/marketplace/states/section-1332-state-innovation-waivers

... section 1332 of the ACA includes potentially expansive waiver authority that holds tremendous promise for new and innovative state-based systems of coverage and care delivery. With these waivers, states can use federal dollars (from Medicaid and beyond) to provide coverage to their residents that is at least as affordable, widespread, and comprehensive as that in the ACA. Although a few states have discussed the use of section 1332 waivers for more dramatic reforms that would affect participants in the individual and small group markets, their use has remained relatively limited because of the measure of control that presidential administrations have to approve applications. Congress should consider legislation that would simplify the waiver application process, clarify and streamline the standards that states must meet to receive a waiver, and create a fast-track process for states that have already received a waiver and want to renew or modify it.

State lawmakers do not have to look far for good ideas to deploy through section 1332 waivers. Over the last 2 decades, demand-side health care reforms have given consumers more control over their health care future. Health savings accounts (HSAs) embody this idea. Although they are not for everyone and are still saddled with restrictions that prevent broader adoption, HSAs are popular with users who willingly forego high-premium plans for an opportunity to save dollars tax-free. The result is a better incentive structure; studies show HSAs have reduced health care use among participants.5

States could use section 1332 waiver authority to adopt similar saving vehicles for Medicaid recipients. This would help not only to promote saving and ownership among beneficiaries, but also encourage smarter consumption of health benefits. States could give Medicaid participants HSA access in conjunction with their coverage and fund those accounts to help offset costs, including co-pays at the point of service. Depending on state budget constraints, these cost-sharing requirements could feature annual out-of-pocket maximums that match the annual contribution to the recipient’s savings vehicle. This would ensure recipients would not be made worse off.

Rules would be needed to prevent withdrawals for nonqualified spending for a certain amount of time. Importantly, like traditional HSAs, participants could spend their accounts on any qualified medical spending, regardless of whether a service is currently covered by Medicaid. For example, Medicaid recipients could use a portion of their contributions to pay for nontraditional coverage options or services that may not be covered, such as dental benefits. In addition, when they leave Medicaid, recipients should be able to retain their HSA balances and use them in conjunction with employer-sponsored or other private plans (subject to existing federal rules governing HSAs).

Dr. Chen has more published articles in the free market healthcare space.
https://jamanetwork.com/searchresults?author=Lanhee+J.+Chen&q=Lanhee+J.+Chen