The State of Georgia on Tuesday slapped Anthem Blue Cross Blue Shield with a $5 million fine after determining the health insurance had engaged in a years-long practice of violating policyholder’s rights.
Insurance and Safety Fire Commissioner John F. King announced the fine during a Tuesday morning press conference at the state Capitol, calling it the largest in the agency’s history.
"[A]fter numerous complaints made to our office regarding the operations of Blue Cross Blue Shield from individuals, physicians, hospitals, and others from around the state, I instructed my staff to conduct an extensive examination into the carrier’s practices," King said. The examination, which spanned several months, uncovered "serious" issues, King said. These included improper claims settlement practices, violations of state law, failure to reply to consumer complaints in a timely manner, inaccurate provider directories and "significant delays in loading provider contacts."
Anthem Blue Cross Blue Shield told FOX Business in a statement the examination focused on a provider database that was implemented in 2015 but is no longer in use. "We have since migrated to a new platform with the goal of improving accuracy and transparent," the company said. "We are dedicated to those we serve and partner with, and we believe the recent enhancements we have made will create an improved overall care provider.
The commissioner’s office said Blue Cross Blue Shield must develop a new plan to address the violations and that it may be hit could be hit with additional fines if it misses certain benchmarks.
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