Blue Cross facing fine after cancelling Springfield Clinic Contract

SPRINGFIELD – Blue Cross Blue Shield of Illinois will be facing a fine of $339,000 for failing to submit required information after terminating a contract. The Illinois Department of Insurance announced Monday that the fines were part of the penalty from failing to allegedly comply with the state’s Network Adequacy and Transparency Act. The Department 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 finally 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, and penalties of $1000 per day.
“Insurance companies must be able to show that they have adequate provider networks, so that Illinois consumers have access to the medical care and providers that they pay for,” said Governor JB Pritzker. “This fine should serve as notice that we will require insurers to maintain adequate provider networks and uphold all consumer protections under the law.”
Blue Cross Blue Shield must pay the fine immediately, and the company has 10 days to contest the fine.