California has fined Blue Shield and Anthem Blue Cross for using inaccurate directories of providers for state Obamacare networks.
Blue Shield of California was fined $350,000 and Anthem was fined $250,000, the California Department of Managed Health Care (DMHC) announced Nov. 3.
The problems date back to early 2014, when the state began receiving complaints about the network directories. The state subsequently found significant numbers of physicians listed in the directories who were not at the location listed and/or were not accepting Covered California enrollees.
Blue Shield has already reimbursed more than $38 million to Covered California customers who incurred out-of-network costs, the DMHC said. Figures were not announced for Anthem.
“The DMHC has taken enforcement action and fined Blue Shield and Anthem due to unacceptable inaccuracies in their directories,” DMHC Director Shelley Rouillard said. “These inaccuracies limited enrollee access to care that resulted in an unacceptable consumer experience and must be fixed.”
The error-riddled physician directories initially provided by Covered California’s web site were an early source of embarrassment as the marketplace first got under way. Those lists were removed from the state’s web site due to many reported problems, with consumers instead directed to health insurance providers’ own lists.
The DMHC said it has initiated a follow-up survey to assess if the plans have corrected the deficiencies identified in the initial survey reports.
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