State Audits Confirm Blue Shield and Blue Cross Misled Consumers About Doctors Available Under Obamacare Plans

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Santa Monica, CA – Two state audits released yesterday confirm a central allegation of twin class action lawsuits brought by Consumer Watchdog against Blue Shield and Blue Cross for dramatically misrepresenting the number of doctors available to consumers under new Obamacare health plans.

"Hundreds of thousands of consumers have been misled about which doctors and hospitals are available to them under new Blue Shield and Blue Cross health plans.  These so-called 'Narrow Networks' have serious consequences for consumers’ pocketbooks if they cannot identify in-network doctors when they need treatment," said Consumer Watchdog lead attorney Jerry Flanagan.  "Consumer Watchdog's lawsuits are dramatic evidence that Californians are having widespread difficulty finding a network doctor."

"We're hopeful that Blue Shield and Blue Cross will quickly resolve these lawsuit and reimburse consumers for the out of pocket payments they were required to make to physicians who they were led believe were part of their plan," said Flanagan. "The state should now audit Cigna, which has also dramatically overstated the number of doctors available to consumers."

•    Download Consumer Watchdog's class action lawsuit against Blue Shield here:

•    Download Consumer Watchdog's class action lawsuit against Anthem Blue Cross here:

•    Download Consumer Watchdog's class action lawsuit against Cigna here:

At least 25% of physicians listed by Anthem Blue Cross and Blue Shield of California are not taking patients enrolled in Obamacare plans or are no longer at the location listed by the companies, according to the state audits.

“When my wife and I enrolled in our new Blue Shield health plan it was important to us that our long-time physicians were included in our plan’s network,” said Kevin McCarthy, the lead plaintiff in Consumer Watchdog’s class action lawsuit against Blue Shield.  “Before enrolling we confirmed through Blue Shield’s website that our doctors were ‘in-network’ and we even called our doctors to double-check.  It was only after we visited our doctors for routine check-ups that the bills started rolling in informing us for the first time that our doctors were in fact out of network and Blue Shield was only covering a fraction of the cost.  Adding insult to injury, when we called Blue Shield to complain we experienced hold times of two to four hours each time we called. I feel Blue Shield is trying to get away with a blatant ‘bait and switch’ and I won’t stand for it!”

The new Obamacare Open Enrollment period began on Saturday and the state audits confirm Blue Cross and Blue Shield continue to misrepresent which doctors are available to consumers.

“Federal health reform has dramatically improved the health care landscape, including important consumer protections that bar insurers from discriminating against those with pre-existing health conditions,” said Flanagan.  “But consumers face threats to their health and financial well-being as a result of the narrow network epidemic."

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