California Department of Managed Healthcare Issues Report on Blue Shield of California Narrow Networks: Validates Current Litigation
On November 18, 2014, the California Department of Managed Healthcare (“DMHC”), the California regulatory body that the state charges with regulating health plans, issued a report concerning Blue Shield of California (“Blue Shield”). This report was prompted by the DMHC’s concerns regarding the accuracy of Blue Shield’s provider directory, the directory that Blue Shield customers and potential customers use to determine which doctors are in Blue Shield’s networks. The DMHC began to look into these concerns in May of 2014 and in June of 2014 it began a survey of the Blue Shield provider directory.
The DMHC learned from the survey that a substantial number of the doctors in Blue Shield’s directory did not practice at the locations provided and a substantial number of the doctors in the directory did not even accept Blue Shield insurance. The DMHC investigation also revealed that Blue Shield failed to adequately comply with its provider list reporting obligations to the DMHC.
These findings comport with the allegations of the class action we recently brought against Blue Shield (McCarthy v. Blue Shield of California) on behalf of Blue Shield members. In these lawsuits, the plaintiffs allege that Blue Shield misrepresented the providers in their network inducing the members to enroll in plans they otherwise would not have and inducing the members to seek services from providers that were out of their network. The DMHC’s findings support the complaints from the numerous victims whom Blue Shield misled into purchasing plans that they could not use and seeking services from doctors for whose services Blue Shield would not provide coverage.
If you or anyone that you know has suffered as a result of Blue Shield’s misleading conduct then contact the Law Offices of Scott Glovsky for a free consultation.