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Blue Cross and Blue Shield of Florida, Inc. (“Florida Blue”)

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On September 4, 2020, our law firm filed a lawsuit against Blue Cross and Blue Shield of Florida, Inc. (“Florida Blue”), GuideWell Mutual Holding Corporation (“GuideWell”), and/or Health Options, Inc. (“Health Options”) (collectively “Florida Blue” or “Defendants”), alleging violations of federal overtime laws. The case was titled Riviere v. Blue Cross and Blue Shield of Florida, Inc., et al., No. 1:20-cv-23709-CMA (S.D. Fla.).

The Complaint alleged that Florida Blue violated the Fair Labor Standards Act by failing to pay its utilization review nurses for the overtime hours they worked. Utilization review nurses’ primary job duty consists of conducting medical necessity reviews, which includes collecting and reviewing medical information and comparing that information to pre-determined guidelines and/or other established policies located to determine whether the authorization request meets the criteria for medical necessity and therefore covered by insurance. They may have varying job titles including Registered Nurses, Concurrent Review and Discharge Nurses, Medicare Pre-Service Medical Review Nurse RNs, Medical Review Nurses, Transitional Review Nurses, Medical Review Nurse LPNs, Concurrent Review RNs, and/or Clinical Review Nurses. 

The named plaintiff brought the case on behalf of herself and all others similarly situated, nationwide, alleging Florida Blue purposefully misclassified its utilization review nurses as exempt to avoid paying overtime wages in violation of under federal law. 

Defendants denied liability but offered to have judgment entered against them and agreed to pay $25,000.00 to the named plaintiff, plus reasonable attorneys' fees and costs. Judgment was entered against Defendants on January 6, 2021.

We believe that there are other utilization review nurses who have worked for Florida Blue who were similarly misclassified as exempt from overtime pay; therefore, we are continuing to investigate the company’s pay practices. If you are interested in learning more about whether you may be eligible to make a claim for back pay, please contact Christina Houston at or (612) 256-3238. 

Our investigation is primarily being handled by Rachhana T. Srey, Esq. of Nichols Kaster, PLLP, 4700 IDS Center, 80 South 8th Street, Minneapolis, MN 55402. Ms. Srey is not licensed in the State of Florida.  She will need to apply to the appear on a one-time engagement basis upon commencement of any matter filed in a federal court in Florida. This investigation is being conducted with the law firms of Berger Montage, P.C. and Shavitz Law Group, PA.

About Nichols Kaster, PLLP:

For more than forty-five years and with currently 39 attorneys, Nichols Kaster has represented employees and consumers nationwide on a variety of legal issues arising under both state and federal laws. The law firm’s National Wage and Hour team, comprised of eight attorneys, represents employees in class and collective actions seeking to recover unpaid wages in circumstances where employers misclassify workers or otherwise fail to compensate them for all hours worked, pursuant to minimum wage and overtime rates, or as required by contract.

About Berger Montague, P.C.:

With over sixty attorneys, Berger Montague PC is a full-spectrum class action and complex civil litigation firm that has represented investors, businesses, consumers, employees, and property owners for more than fifty years. Berger Montague is experienced in class action litigation, seeking remedies for employees under the Fair Labor Standards Act, state wage and hour law, breach of contract, unjust enrichment, and other state common law causes of action. Berger Montague’s Employment & Unpaid Wages Group is comprised of 66 attorneys.

About Shavitz Law Group, PA:

Since 1999, Shavitz Law Group, has represented employees, focusing exclusively on employee rights and wage and hour class action litigation. The Shavitz Law Group is based in Boca Raton, Florida. The firm also handles claims for employees in whistleblower, Equal Pay Act, discrimination, and retaliation cases. 

Type of Investigation

Unpaid Overtime