Clinic business

Blue Cross Blue Shield pays fine for dispute with Springfield clinic – WLDS

Blue Cross Blue Shield has paid a $339,000 fine issued earlier this month by the Illinois Department of Insurance for the company’s failure to report major changes in its provider network and resulting policy changes of its ongoing dispute with Springfield Clinic.

About 100,000 people have been affected by the split between the insurance giant and one of the largest in central Illinois

The Illinois Department of Insurance issued the fine earlier this month after thousands of the company’s customers lost access to Springfield Clinic providers.

WCIA’s Mark Maxwell later found that several clients had discovered that other physicians in the licensed network were not taking patients and sometimes were not even located in Illinois.

In a statement released yesterday, the insurance giant said it paid the fine, but is still seeking to clarify the state’s rules and how they are enforced.

Blue Cross-Blue Shield also says it continues to pursue an agreement with Springfield Clinic. WICS Newschannel 20 reports that Harmony Harrington, vice president, government and community relations, Blue Cross and Blue Shield of Illinois, says the central problem in the conflict with the Springfield Clinic is exorbitant demands: “The central problem remains: the Springfield Clinic is a for-profit entity demanding a staggering 75% increase even though its rates are the highest in the Springfield market and 60% higher than Chicago Health care is not accessible if it is not are not affordable.

The fine was the first time IDOI has fined a company for non-compliance with the Network Adequacy Transparency Act, a law that requires insurance companies to provide a list of healthcare facilities are accessible and meet appropriate time and distance standards for clients.