1 year ago
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FRESNO, Calif. (KSEE/KGPE) – Blue Shield of California was ordered to wage astir $500K aft illegally billing wellness program members for contraceptive wellness attraction services, the California Department of Managed Health Care (DMHC) says.
According to authorities law, wellness plans successful California are required to screen contraceptive drugs, devices, and products approved by the Food and Drug Administration, including related follow-up services for free.
DMHC says the security institution was fined $250,000, and ordered to reimburse 334 members a full of $228,254 for wrongfully charging a outgo stock related to covered contraceptive wellness attraction services betwixt 2016 and 2019.
“Under the law, wellness plans indispensable screen contraceptive wellness attraction services for each members without imposing a deductible, coinsurance, copayment oregon immoderate different cost-sharing requirement,” said DMHC Director Mary Watanabe. “The program violated the instrumentality erstwhile it charged members for covered contraceptive wellness attraction services.”
DMHC says the $228,254 successful reimbursements came aft an enquiry that followed a subordinate who filed a grievance with the plan, but the program continued to measure the member. The subordinate past filed a ailment with the DMHC Help Center which led to the broader probe and identified 334 different wrongfully charged members.
The DMHC encourages wellness program members experiencing issues with their security providers to travel suit and record a complaint. If the contented is not resolved wrong 30 days, the DMHC recommends members interaction the DMHC Help Center at www.DMHC.ca.gov or 1-888-466-2219.
