Blue Cross of California fined $1.1M, will reimburse enrollees $9.2M

Blue Cross of California has agreed to issue $9.2 million in reimbursements to members who were incorrectly required to pay office visit costs as part of their deductibles. 

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The agreement was part of a corrective action plan issued by the California Department of Managed Health Care, which also fined the payer $1.1 million, according to a June 9 news release from the department. 

The department fined Blue Cross $750,000 for incorrectly applying the office visit costs, which affected more than 6,500 enrollees between 2015 and 2020, according to the news release. These included primary care, and behavioral health office visits. 

Blue Cross was also fined $360,000 for failing to mail required explanation of benefits information to more than 360,000 enrollees, according to the news release.

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