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

No Company is Too Big to Play Fair.

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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.

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Type of Investigation

  • Unpaid Overtime

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No Company is Too Big to Play Fair

When it comes to the unfair treatment of employees and consumers, our lawyers and legal professionals are prepared to fight for what is right.

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