Blue Cross and Blue Shield of Texas, A Division of Health Care Service Corporation of Chicago, IL
Order Number: 080514
Date of Order: 6/13/2008
Order Final In: June
Action Taken: $250,000 fine with additional fine of $3,900,000 subject to possible dollar-for-dollar reduction to zero by restitution paid
Violation: Failed to make non-preferred benefits reasonably available to its insureds; Failed to maintain an accurate listing of its preferred providers
Editor’s Note: PPO networks change almost daily. So how does one maintain an accurate listing of its preferred providers?