The Georgia state commissioner’s office has ordered Blue Cross Blue Cross Shield of Georgia Inc. to pay additional claims of $12 million to policyholders for ambulance services, according to the Dawson Times, a local paper in Georgia.
A market conduct exam revealed Blue Cross incorrectly reimbursed out-of-network service providers, and made inconsistent payments for comparable services. The insurer also failed to increase its reimbursement rates as service costs rose.