Blue Shield of California erroneously cancels coverage for undisclosed number of members

In recent months, some Blue Shield of California members reported sudden, erroneous cancellations of their individual policies, according to the Los Angeles Times.

Coverage losses have forced some members to pay for medical care out of pocket, skip vaccinations for their children or leave prescription drugs unfilled, according to consumer complaints cited in the report.

Enrollment and billing issues have plagued Blue Shield's individual policies since 2014, for plans on and off the state's ACA exchange. Blue Shield did not specify how many members may have been affected by the erroneous cancellations, according to the report.

In a lawsuit filed June 22, Blue Shield blamed its third-party contractor, HealthPlan Services, for the coverage lapses. In a countersuit filed Aug. 13, HealthPlan Services denied Blue Shield's allegations and accused the health insurer of providing inaccurate member data to the contractor. Blue Shield moved to terminate its contract with HealthPlan Services in April 2017.

At the end of last year, the California Department of Managed Health Care fined Blue Shield and one of its subsidiaries $557,500 for improper coverage cancellations and other member grievance violations, according to the Los Angeles Times. The state said Blue Shield is contesting some of the fines and allegations.

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