SPRINGFIELD, Ill. (WCIA) — The Illinois Department of Insurance has fined a major insurance company for not updating their provider directory in a timely manner.

The state agency previously fined Blue Cross Blue Shield in March more than half a million dollars for violating laws related to network adequacy. Agency officials say they have fined the company an additional $231,900 because Blue Cross Blue Shield has delayed implementing changes to their provider directories to address the network adequacy violations from the first fine.

“Consumers rely on their health insurance companies to provide accurate information, so that they can make important, informed decisions about their health care,” IDOI Director Dana Popish Severinghaus said in a statement. “Provider directories are often the first touchpoint for health insurance consumers attempting to choose a primary care physician or specialist. Inaccurate, outdated, confusing information can make that selection process even more time-consuming and stressful. In Illinois, health insurers with provider directories found to be in violation of the law will be fined.”

According to the department, BCBS’s parent company, Health Care Service Corporation, has now improved their search processes on the directory to now be compliant with the IDOI director’s order. IDOI officials say they will conduct follow-up exams to ensure the company remains in compliance with the Network Adequacy and Transparency Act.

The WCIA Target 3 investigative team released a series of investigations on Blue Cross Blue Shield violating continuity of care in Spring 2022.

Blue Cross Blue Shield provided WCIA with the following statement in response to the fine:

Blue Cross and Blue Shield of Illinois strives to provide its members with an accurate and usable provider directory. We recently completed a series of updates to our online directories to make them easier to use for our members and prospective members.

When we learn information is inaccurate or incomplete, we fix it. Information related to the four providers noted in the Department’s order was corrected in May.

BCBSIL cooperates with the Department and our active engagement with the Department is one of the ways we help ensure we are best serving the needs of our members.

Any member with questions about their network or plan benefits, should contact us using the number on the back of their member ID card.

John Simley, Director of Communications for Blue Cross and Blue Shield of Illinois

The president of the Illinois State Medical Society also gave a statement to WCIA on IDOI fining Blue Cross Blue Shield.

“The Illinois State Medical Society is pleased to see the Illinois Department of Insurance using the authority granted to them under the ISMS-backed Network Adequacy and Transparency (NAT) Act and holding Health Care Service Corporation, the parent company of Blue Cross Blue Shield of Illinois, accountable for yet another violation. 

It’s remarkable that this company continues to ignore the NAT Act’s requirements to maintain up-to-date, accurate and complete provider directory information for their customers – the patients of Illinois. Inaccurate directory information is frustrating to patients and leads to delays in care. Instead of paying repeated fines now totaling well beyond a million dollars for continued violations of the NAT Act, do the right thing and keep those directories up to date so patients can get the healthcare they deserve.”

Rodney S. Alford, M.D., M.B.A., President of the Illinois State Medical Society