Anthem, MU Health Care fail to reach deal; MU Health will be out-of-network for Anthem customers on Tuesday

COLUMBIA, Mo. (KMIZ)

Anthem Blue Cross Blue Shield and MU Health Care failed to reach a deal on Monday, according to a Monday news release from MU Health Care.

The two sides had been in contentious negotiations for months with the intent to reach an agreement by Monday’s deadline. MU Health Care will no longer be considered within Anthem’s network on Tuesday. Anthem’s Medicare Advantage customer will also be no longer in-network at MU, according to previous reporting.

MU Health Care says in its news release that Anthem walked away from the negotiations.

The release says the change does not impact Healthy Blue Medicaid or University of Missouri Student Advantage plans, prescriptions Anthem members get through Mizzou Pharmacy or patients who need medically necessary emergency care.

MU Health Care CEO Ric Ransom was highly critical of Anthem in a letter to the insurance giant that was shared with reporters.

"To say Anthem's behavior toward MU Health Care throughout our contract negotiations is unfortunate is putting it mildly," he wrote. "Your actions have put your members -- and our patients -- in a troublesome, frustrating and perilous situation."

Anthem said in a statement that MU Health called off negotiations.

"We’re disappointed that MU Health Care cancelled the negotiation meeting that was scheduled for today instead of providing a response," Anthem says in the statement. "Our current proposal, valid until midnight, includes reasonable payment increases that are in line with other Missouri health systems. MU Health Care’s proposed price increases would increase healthcare costs many times faster than wage growth for Missouri consumers. We cannot agree to price hikes of this magnitude for our members. Standing up for affordable care for all Missourians is part of our mission."

MU Health Care recommended last month for patients to apply for continuity of care to extend in-network coverage. A call center for patients is available at 573-650-5409 from 8 a.m.-6 p.m. Monday-Friday.

Continuity of care according to MU Health Care may include:

• Pregnancy
• Serious or complex conditions like cancer and currently undergoing a course of treatment
• Relapsed cancer and currently receiving chemotherapy, radiation therapy or reconstruction
• Transplant candidates or recipients in need of ongoing care due to complications
• Recent or scheduled non-elective surgeries in the acute phase, including post-operative care
• Serious acute or chronic conditions in active treatment (e.g. heart attacks or strokes)
  • Acute conditions that are serious enough to require specialized medical treatment to avoid the reasonable possibility of death or permanent harm
  • Chronic conditions that are life-threatening, degenerative, potentially disabling or congenital and require specialized medical care over a prolonged period of time
• Terminal illness requiring care

Anthem says once you submit a forum it will take up to 10 days to know whether your application was approved.

According to Anthem, it is working with other Mid-Missouri health care providers which includes, Boone Hospital, SSM St. Mary's, Moberly Regional Hospital and Jefferson City Medical Group.

Insurance agent Ashley Rohrbach with Health Insurance Solutions told ABC 17 News she believes both sides will eventually go back to the negotiation table.

"Eventually, just from past experiences with larger insurance companies with their negotiations, once they realize...once Anthem realizes they're losing a lot of customers, I think they're going to have to negotiate, as well as MU is going to have to negotiate too a little bit on their side," Rohrbach said.

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.