MU Health Care warns of coverage loss for Anthem policyholders as contract deadline looms
COLUMBIA, Mo. (KMIZ)
With a deadline looming to finalize insurance negotiations, MU Health Care warns that Anthem Blue Cross Blue Shield policyholders may soon face coverage disruptions, as little progress has been made in discussions.
MU Health Care has been in negotiations with Anthem for months, with a contract between the two parties expiring on March 31. If the two sides don’t come to an agreement, MU Health Care will be considered out of Anthem’s network coverage on April 1.
“Looking at the timeline, we're more concerned and taking more steps to communicate with and identify patients that have appointments scheduled in April, particularly in the first couple of weeks of April, because we know that that's where potentially, if out-of-network, the most impact would be felt,” Dr. Laura Morris, Chief Medical Officer for Ambulatory Care at MU Health Care said.
On Monday night, MU Health Care sent an email to students and customers that provided an update on stalled negotiations and expressing disappointment over the ongoing uncertainty. In the email, MU Health Care expressed disappointment in “Anthem’s actions throughout this process” and encouraged members to contact their employer or call Anthem using the number on the back of their insurance ID card to advocate for continued in-network access to MU Health Care services.
In a statement to ABC 17 News on Tuesday, Anthem said it remains committed to keeping MU Health Care in its network, but criticized the health system for canceling negotiation meetings and demanding a 39% price increase over three years. The insurer argued that such increases would drive up healthcare costs significantly for Missouri consumers and urged MU Health Care to return to the negotiating table.
“MU Health Care’s proposed price increases would increase healthcare costs many times faster than wage growth for Missouri consumers,” Anthem wrote in the statement. “We ask MU Health Care to return to the negotiating table and join us in working to keep care accessible and affordable for our community.”
However, MU Health Care spokesman Eric Maze said negotiations are still ongoing. According to Maze, MU Health Care met with Anthem representatives on Monday, with more meetings scheduled for Wednesday, Thursday and Friday.
“What we're looking for with Anthem is reasonable increases. Things that are keeping pace with other academic health systems, things that allow us to keep pace with the cost of providing care to patients.” Morris said. “In addition to a rate increase, a number is one thing, but we're also looking for some relief of the administrative burden of managing that contract and of dealing with those claims. A lot of the claims that Anthem processes are denied at an increased rate. Claims are outstanding for a longer duration of time. It requires a staff of over 30 people at MU health care just simply to manage this claims process for our patients.”
If an agreement is not reached by March 31, Anthem and HealthLink plans that patients get through their employer or the Affordable Care Act will go out of network. While Medicare Advantage plans will be out of network, Maze says that negotiations will still continue for commercial insurance and Affordable Care Act insurance.
“Patients are nervous. We know this. I just had clinic this afternoon and saw several patients who have Anthem insurance and they are all asking me these questions,” Morris said. “I saw a pregnant patient who has Anthem coverage and she's concerned about how she's going to finish care for the rest of her pregnancy. We know folks are nervous and that's why we continue to come to the table.”
MU Health Care previously suggested for patients to apply for continuity of care.
Anthem said it is taking steps to help members transition to alternative providers. Employer-sponsored health plan members receiving treatment for serious or complex conditions will have in-network benefits extended for a limited time after April 1, or until their treatment is completed. Medicare Advantage members authorized for treatment at MU Health Care will also have in-network benefits extended until their care can be safely transferred. Anthem advised affected members to contact its service center for assistance. Medicare Supplement plan members will not be impacted by the negotiations.
About 2 million Missourians are insured through Anthem, according to the company's website. Roughly 100,000 patients are insured through Anthem at MU Health Care, according to previous reporting.
Check back for updates
