CHICAGO (WMBD) — The Illinois Department of Insurance announced that it has fined the parent company of Blue Cross Blue Shield of Illinois on Friday.
According to the department, Health Care Service Corporation was fined $231,900 for allegedly violating the Network Adequacy and Transparency Act.
The Act requires health insurers to post accurate, up-to-date and complete directory information.
Earlier this year, after an examination of Blue Cross Blue Shield of Illinois, the state fined HCSC for not being in compliance with the Act, and ordered it to take corrective action, including making information clearer to customers and updating provider’s directories.
These new fines are due to the health insurer’s alleged delayed compliance with implementing the change.
“Consumers rely on their health insurance companies to provide accurate information, so that they can make important, informed decisions about their health care,” IDOI Director Dana Popish Severinghaus said. “Provider directories are often the first touchpoint for health insurance consumers attempting to choose a primary care physician or specialist. Inaccurate, outdated, confusing information can make that selection process even more time-consuming and stressful. In Illinois, health insurers with provider directories found to be in violation of the law will be fined.”
The Director of Communications at Blue Cross and Blue Shield of Illinois, John Simley, also shared a statement
Blue Cross and Blue Shield of Illinois strives to provide its members with an accurate and usable provider directory. We recently completed a series of updates to our online directories to make them easier to use for our members and prospective members.
When we learn information is inaccurate or incomplete, we fix it. Information related to the four providers noted in the Department’s order was corrected in May.
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.
Any member with questions about their network or plan benefits, should contact us using the number on the back of their member ID card.
John Simley, Director of Communications at Blue Cross and Blue Shield of Illinois
The department said HCSC is now complying with the requirements by the state including:
- Creating an improved search process within its provider directories so that consumers can more easily find providers for their particular plan and health care needs, and within their geographical area. The improved search includes more distinct naming of plans, fewer acronyms, and the use of zip code specificity.
- When a consumer selects their particular plan, the consumer can search by specialty type and/or diagnosis to find the right provider for their health care needs.
- When a list of providers is shown to the consumer, a new filter will highlight the providers’ up-to-date and verified information including, telehealth services, the providers’ acceptance of new patients, location, phone number and other information.
- For providers who are in-network for facility or hospital admitting rights only, those providers will no longer show in specific health plans to avoid confusing consumers who are searching for doctors and specialists available for in-office visits. The providers with limited access will be listed in the All Plans/All Providers section.
The Insurance Department will continue to follow up with HCSC to ensure it remains in compliance.
