Blue Cross Blue Shield fined by state after failing to submit required information after terminating Springfield Clinic contract

Posted on March 21, 2022
Illinois Department of Insurance found BCBS of Illinois violated the Network Adequacy and Transparency Act. (Photo courtesy: HOI/ABC)

By Heart of Illinois ABC

SPRINGFIELD – The parent company of Blue Cross Blue Shield of Illinois, Health Care Service Corporation, has been fined by the Illinois Department of Insurance $339,000.

The state says this first-ever action was taken because Health Care Service Corporation violated the material change notice requirement in Illinois’ Network Adequacy and Transparency Act.

A release from the state says network adequacy filings are an important tool to help ensure that consumers have access to a network of providers that meets proper time and distance standards.

The Department of Insurance found that the company did not properly file updated network adequacy filings following the termination of its contract with Springfield Clinic which serves approximately 100,000 consumers in Central Illinois.

After months of delay, the department received BCBS’s final filing for its network adequacy review on Thursday.

The department determined that the filings were 244 days late and 95 days late, accumulating a total fine of $339,000; Late fees are $1,000 per day.

Blue Cross Blue Shield must pay the fine immediately and the company has 10 days to contest the fine, according to the state.

The Department of Insurance will continue its review of the network adequacy filing for compliance with applicable state and federal laws.

Heart of Illinois ABC can be reached at [email protected].

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