Dive Brief:
- California’s Department of Managed Health Care fined Anthem Blue Cross $415,000 this week for its unsatisfactory response to consumer grievances, California Healthline reported.
- The regulating agency reported finding 40 cases in which the insurer failed to abide by members' grievance and appeal rights.
- In addition to the fine, the agency is requiring Anthem to provide a detailed report within 90 days on how it is fixing the identified violations.
Dive Insight:
Anthem, which sells Blue Cross policies in 14 states, is taking the heat over grievance violations just as it hopes to achieve state and federal regulatory approval for its deal to acquire Cigna later this year.
The insurer is paying the fine and working to address the issue, Anthem spokesman Darrel Ng told California Healthline.
“In order to resolve the issues identified by the Department of Managed Health Care, Anthem has provided additional training to its staff and implemented a new tracking system to reduce delays with the grievance and appeals system,” he said.
Opponents of the upcoming merger have pointed toward Anthem's historic issues with the grievance process as a reason to halt the deal, noting the company has been fined more than $2 million for the same issues since 2011, and suggesting the problem could be magnified if Anthem is allowed to grow.