$5M fine against BCBS largest in Georgia regulator's history

Georgia's insurance commissioner has fined Blue Cross Blue Shield $5 million for violations of state laws and agency rules and regulations, the commissioner's office said March 29. 

The fine comes after the office received numerous complaints regarding BCBS from individuals, physicians, hospitals and others from around the state, according to a news release from the office. Georgia Insurance and Safety Fire Commissioner John F. King instructed his staff to conduct an extensive examination into the carrier's practices. 

The examination uncovered a number of serious issues, according to the news release. The issues included improper claims settlement practices, violations of the Prompt Pay Act, failure to reply to consumer complaints in a timely manner, inaccurate provider directories and significant delays in loading provider contracts.

Those findings resulted in the largest fine in the agency's history, Mr. King said in the news release. 

BCBS must develop a new process for handling regulatory provider complaints, pay claims within the time frames established under state law and load provider contracts in a timely manner. The company may face additional fines if it misses certain benchmarks in the corrective action plan.

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