California’s Department of Managed Care released a highly critical report last week saying Anthem Blue Cross and Blue Shield of California haven’t been upfront with current and prospective members concerning doctors participating in the state’s public health insurance exchange, Covered California.
According to the state, neither of the two health plans has corrected three of four problems identified by regulators. Among the issues is that one-fourth of the physicians listed by Anthem and Blue Shield were not taking Covered California patients or were not found at the address listed by the health plans.
“We found the provider directories made available to the public had significant errors,” said Shelley Rouillard, director of the California Department of Managed Care. “When you have a quarter or more of physicians that aren’t available, that is significant.”
The state’s report is based on a survey of doctors listed in the provider directories for the two insurers. Doctors were asked about their contracting with the plans for members enrolled in the state exchange – and whether they were accepting new patients.
Anthem and Blue Shield, which account for nearly 60 percent of Covered California enrollment, criticized the report saying the state’s survey was flawed and the report exaggerates a problem they are currently working to correct.
Consumer advocates are pushing the state to impose substantial fines on the two insurers, although it’s not known what penalties could be levied.