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7 payer’s violations that received fines in 2025 were outlined in Becker’s Payer Issues

  1. Anthem Blue Cross of California
  2. Centene’s Human Affairs International of California subsidiary was fined $300,000 by the state in June for failing to meet timely access to healthcare appointment compliance standards, specifically for urgent care appointments, as required under the Knox-Keene Health Care Service Plan Act. 
    1. **California’s timely access to healthcare appointment standards requires health plans to provide timely access to care, ensuring members receive appointments within specific timeframes for urgent and non-urgent services.  For Urgent Care that time frame is 2 days. For a flyer on these requirements see the CADMC website.**
  3. UnitedHealthcare
  4. BCBS Rhode Island
  5. Aetna
  6. Blue Shield of California
  7. Cigna

For details on violations and fines applied to the other payers see the Becker’s Payer Issues article linked above.

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