The Illinois Department of Insurance has fined Health Care Service Corp., the parent company of Blue Cross Blue Shield of Illinois, nearly $1.2 million in less than two years for violating the state's Network Adequacy and Transparency Act, which requires payers to publish complete and accurate provider directory information.
The latest fine for $231,900 is because HCSC did not update its directory for network changes with four providers within 10 business days, as required by state law, according to a Nov. 3 news release. The payer also did not institute corrections to its provider directory within 90 days following a January 2023 order from the state.
The state said HCSC is now in compliance because it made changes to its provider search process.
BCBS Illinois was fined $605,000 by the state in March following a market conduct exam. The investigation found the payer failed to follow some network transparency standards, including failure to audit at least 25 percent of provider directories for accuracy. In March 2022, BCBS Illinois was fined $339,000, the first insurer to be fined under the state's network adequacy law, after it did not properly file an updated directory following the termination of its contract with Springfield (Ill.) Clinic in November 2021.
In a statement provided to Becker's, BCBS Illinois it "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."