The parent company of Blue Cross Blue Shield of Illinois received another fine from the state Friday, now its third in the past two years.
Health Care Service Corporation received a $231,900 fine from the Illinois Department of Insurance due to having an inaccurate and incomplete provider directory. Collectively, Blue Cross has received nearly $1.2 million in fines from violations of the Network Adequacy and Transparency Act since 2022.
The latest fine, IDOI says, comes after the health insurance company failed to comply with implementing changes as ordered by its most prior $605,000 NATA violation in March. The act requires insurers to update their directories within 10 business days if any changes are made, which Blue Cross was in violation with four providers.
IDOI Director Dana Popish Severinghaus described the directories as the “first touchpoint” for customers trying to find in-network primary care physicians or specialists.
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“Inaccurate, outdated, confusing information can make that selection process even more time-consuming and stressful,” Severinghaus said in a news release.
John Simley, director of communications at Blue Cross and Blue Shield of Illinois, said in a statement that the insurer will comply with the orders from IDOI. Those orders include creating a search option within its directory that allows for consumers to find providers based on their healthcare needs or within a geographic area.
Simley said the insurer has also updated the information regarding the four providers along with overall improvements to its directories, which Blue Cross says will increase ease of access for its customers.
“BCBSIL cooperates with the Department and our active engagement with the Department is one of the ways we help ensure we are best serving the needs of our members,” Simley said.
The fine come as Rep. Sue Scherer, D-Decatur, is calling on fellow legislators to take-up her “ghost networks” bill which would establish a $5,000 monthly penalty for insurers with not up-to-date provider lists. Her bill would also grant IDOI broader emergency rule-making ability to establish federal-level standards for travel time and distance, provider ratios, and appointment wait times if they exceed those of the state.
With veto session resuming this week, it appears unlikely that House Bill 4126 will be called before the scheduled Thursday adjournment as it awaits in the House Rules Committee.
Contact Patrick M. Keck: 312-549-9340, pkeck@gannett.com, twitter.com/@pkeckreporter.
Clinton Mora is a reporter for Trending Insurance News. He has previously worked for the Forbes. As a contributor to Trending Insurance News, Clinton covers emerging a wide range of property and casualty insurance related stories.