Here are five observations:
1. CMS’ new regulations allow the agency to fine payers up to $25,000 per beneficiary for errors in Medicare Advantage plan directories and up to $100 per beneficiary for errors in plans sold on the federally run insurance exchanges in 37 states.
2. California fined Anthem Blue Cross $250,000 and Blue Shield of California $350,000 in November after a survey revealed more than 25 percent of physicians listed in their 2014 state directories were not at the listed locations or denied accepting those plans.
3. Following the survey, a Blue Shield spokesman said the insurer paid more than $38 million in claims adjustments during the past two years.
4. Many consumers have complained health plan provider directories failed to name physician who have died, moved, retired, changed affiliation or do not accept certain insurance.
5. The new regulations force insures to contact all network providers ever quarter to verify listings.
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