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50-percent test accident or health agreements alleged anticompetitive antitrust laws appeal apply Appropriateness Ball Memorial Hospital beneficiary benefit plan bill Blue Cross Blue Shield buyer cafeteria plan claims competition competitors core health court found coverage credentialing creditors Cross and Blue decision denial denied determine discount drug benefit drug costs effect employer-provided benefit entity ERISA fees group boycott Hassan health benefits health plans highly compensated employees hospital's including generic quality Indemnity Independent Practice Associates issues liability limit managed Maricopa market power medical necessity merger nondiscrimination rules ostensible agency participating patient payment Payor percent pharmacies pharmacists physicians plaintiff podiatrists PPO sponsor premiums prescription drug price fixing procedures proposed regulations Provider Network qualification rules quality screens radiologists rates Reazin refusal to deal reimbursement requirements restraint risk rule of reason selection standards subscribers Total Health transition rule treating physician utilization review violation