Anthem Blue Cross Blue Shield has filed a legal motion to end a court’s temporary restraining order that, at least temporarily, has kept Northside... Anthem seeks to halt court order continuing Northside contract

Anthem Blue Cross Blue Shield has filed a legal motion to end a court’s temporary restraining order that, at least temporarily, has kept Northside Hospital facilities in the giant insurer’s network.

Northside Hospital was granted an injunction by Fulton County Superior Court just before its Anthem contract was scheduled to be severed Jan. 1. That injunction – which preserved Anthem members’ in-network status with Northside — lasts till Jan. 31.

For months, the two sides have been unable to reach agreement on reimbursement rates for medical services.

More than 400,000 Anthem patients in metro Atlanta who use Northside hospitals, clinics and physicians are caught in the middle of the contract rift.

Anthem is asking the court to end the injunction and compel an arbitration process to resolve the contract issues.

The five-hospital Northside system noted that the legal battle comes during an explosion of Covid cases, driven by the highly contagious Omicron variant. Northside said it had more than 600 Covid-19 patients in its Atlanta-area facilities Tuesday, representing nearly half of its inpatient bed capacity.

Northside said Anthem’s request to end the injunction shows that the insurer “is still attempting to force patients out of the Northside network even earlier” than scheduled end of the injunction Jan. 31.

In its court filings to delay the end of the contract, Northside cited a new Georgia law that went into effect in July.

House Bill 454 includes a provision saying that during a public health emergency, an insurer is prohibited from ending such a contract with a medical provider.

Northside Hospital Gwinnett

 

The hospital system said it’s “attempting to continue its discussions with Anthem, with the intention of reaching a long-term agreement that provides the best benefits to patients and their families. We urge all Anthem members to contact Anthem to voice their concern with this behavior.”

Anthem said in a statement Tuesday that its members can seek emergency care at any hospital, no matter whether it’s in the insurer network or not.

“Ensuring access to care is why we began negotiations early and have been working in good faith for seven months to reach a new agreement with Northside,’’ said Anthem spokeswoman Christina Gaines.

Her statement added: “We have given Northside a proposal with generous increases – one they could sign immediately – yet they have refused. Northside wishes to continue operating under a contract that will not achieve the affordability or quality improvements we have been seeking, and our members deserve. We’d like Northside to join us in focusing solely on reaching an agreement that is in the best interests of consumers.”

(Here’s a recent GHN/Kaiser Health News article on insurer/hospital contracts.)


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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