Anthem BCBS has reached an agreement with VCU Health for member healthcare coverage, while negotiations with Bon Secours remain unresolved. This situation has led to Anthem Medicare Advantage patients being out-of-network since August. The VCU Health deal covers various Anthem BCBS plans. Bon Secours and Anthem split recently after unsuccessful negotiations due to payment disputes. Currently, only Anthem Medicare Advantage patients are affected, with potential impacts on Anthem Managed Medicaid patients in October. Other Anthem plans remain unaffected.
In recent developments, Anthem Blue Cross Blue Shield (BCBS) has successfully forged a coverage agreement with VCU Health, though the same cannot be said for its dealings with Bon Secours. This has led to a situation where Anthem Medicare Advantage beneficiaries have been rendered out-of-network since the beginning of August.
The insurance giant, Anthem Blue Cross Blue Shield, has sealed a multi-year accord with VCU Health, a healthcare system in Richmond’s environs. This agreement encompasses Anthem BCBS members enrolled in various plans, including those tied to employers, the Health Insurance Exchange, Medicaid, and Medicare Advantage.
Conversely, Bon Secours remains embroiled in discussions without a firm agreement to offer in-network services in conjunction with the insurance provider.
The severance between Anthem and Bon Secours took place over a fortnight ago, following months of unsuccessful negotiations. Bon Secours cites insufficient remuneration from Anthem as a cause, stating that it does not adequately account for the rising costs attributed to medical professionals due to inflation.
Presently, the impact of these circumstances is primarily felt by individuals with Anthem Medicare Advantage as their primary insurance. However, a representative from Bon Secours mentioned on Thursday that Anthem Managed Medicaid patients might also face the prospect of being considered out-of-network, commencing from the first of October.
For now, individuals holding Anthem employer-provided plans or those directly purchased from Anthem are not subject to these effects.
