Imagine the scandal of your local hospital getting charged $5 million for failing to treat patients in emergencies or your supermarket being fined $5 million for failing to report a salmonella outbreak in its poultry. This kind of news would rattle some cages and hopefully spur some significant course correction.
Now imagine if you heard that Blue Cross Blue Shield of Georgia, Inc. was being fined $5 million for blatantly violating state regulations. Unfortunately, this scenario is not a hypothetical.
After receiving numerous complaints from individuals, doctors, and hospitals, the state began a months-long investigation that found the payor processed in-network claims as out-of-network, and seemingly without grounds rejected claims for “unknown reasons.”
As a result, according to a March 29th article in FOX 5 Atlanta, the state of Georgia issued its biggest fine in the history of its Insurance and Safety Fire Commission against Blue Cross Blue Shield (BCBS) Healthcare Plan of Georgia, Inc.
And the Georgia Insurance and Safety Fire Commissioner’s Office did not hold back on their message about it, tweeting: “As a Police Chief and General, my job has always been to protect Georgians – and that is still my top priority. Today, I levied the biggest fine in department history to protect Georgia consumers against unfair health insurance practices.”
And if BCBS doesn’t straighten up and fly right, more penalties could be on the way.
While we’re glad that the state of Georgia is digging in and issuing fines, we have to call attention to the thousands of unnamed patients and providers harmed by this behavior. Think about the patients who erroneously had claims rejected. Think of the bills they opened at their mailboxes. Think about the doctors trying to heal patients and not being appropriately reimbursed for the hours they spent providing care.
If any other business incurred such a steep fine for breaking the law, we’re sure there would be a reckoning. But insurance companies seem to treat fines and penalties as the cost of doing business.
So while this fine may be historically significant in Georgia – sadly, we’re not so sure it’ll do much in the way of deterring BCBS from future transgressions.
