Anthem Blue Cross–LB Memorial stop negotiations with termination of services

Assemblymember criticizes insurance company for timing and method of notification

Update: MemorialCare has reached a definitive agreement with Anthem for hospital contracts, according to both agencies and Assemblymember Patrick O’Donnell. Effective retroactively to Aug. 15, 2017, MemorialCare hospitals continue to be in-network providers for all Anthem members.

Cory Bilicko | Signal Tribune
Effective Aug. 15, the contract between Long Beach Memorial Medical Center (pictured) and Anthem Blue Cross has been terminated, and the insurance company has discontinued services at the hospital and removed it as an in-network provider.

Monthslong contract negotiations between Anthem Blue Cross and Long Beach Memorial Medical Center abruptly ended last week and resulted in the insurance company discontinuing services at the hospital and removing it as an in-network provider, effective Aug. 15.

Although a state assemblymember has denounced Anthem for its method of delivery and timing in notifying members, a spokesman for the company said MemorialCare– the healthcare system that includes Long Beach Memorial Medical Center– terminated the contract in an effort to acquire greater reimbursement rates.

On Aug. 23, the office of 70th District Assemblymember Patrick O’Donnell provided the Signal Tribune with a copy of the letter Anthem Blue Cross sent to its members. The letter states, “Your healthcare needs are very important to us, and we are committed to providing you with exceptional service. Please be assured that your healthcare coverage will not be interrupted and that this termination will not result in a change to your covered benefits.”

In an emailed statement, O’Donnell criticized the insurance company, saying enrollees were given no prior notice and were informed in a letter received after Aug. 15 that directed them to seek alternate contracted facilities for care.

“I am outraged to learn that thousands of families will no longer be served by Long Beach Memorial Medical Center if Anthem Blue Cross is their healthcare provider,” O’Donnell wrote. “I call on Anthem Blue Cross to immediately reinstate the Long Beach Memorial Medical Center and complete its mission of providing the responsible and adequate health care that enrollees have come to expect. Anthem Blue Cross should negotiate with Long Beach Memorial Medical Center, not patient lives.”

However, in an emailed response to the Signal Tribune, Colin Manning, staff vice president of regional and state public relations for Anthem, presented a different version of how the services came to be terminated.

“Anthem is disappointed that MemorialCare chose to terminate their contract with Anthem in order to demand an excessive increase in reimbursement rates,” Manning wrote. “Anthem has been in discussions with MemorialCare for months in an attempt to resolve this matter. Discussions continued until the eleventh hour, when MemorialCare made the decision to terminate the Anthem contract with its five hospitals. We’re disappointed we were not able to reach an agreement with MemorialCare that would allow us to achieve the appropriate balance between access and affordability for our members.”

Manning added that Anthem is not opposed to resuming negotiations.

“We are willing to return to good-faith discussions if and when MemorialCare is ready,” he wrote.

An emailed response to the Signal Tribune Thursday morning from Lori Weaver, executive director of Managed Care for MemorialCare Health System, seemed to indicate that her company is also open to continuing negotiations with Anthem.

“We continue to diligently work towards a fair and reasonable contract to come to a suitable solution so that our patients and our community can continue to receive uninterrupted exceptional care,” Weaver wrote. “MemorialCare Health System’s hospital agreements with Anthem Blue Cross ended on Aug. 15, 2017 for some of Anthem’s members that use the hospital. This does not impact the Anthem members who are part of the Anthem-Vivity plan, nor does it impact Boeing employees, and this also does not impact Anthem members on Medicare since these are different contracts.”

Weaver then elaborated on MemorialCare’s point of view in the contract negotiations.
“We are asking Anthem to recognize and honor the value and importance of the services we provide to our communities on behalf of our patients, our physicians and our hospitals by negotiating a modest annual increase so that we are reimbursed fairly for the exceptional medical care we offer to the Anthem members that we serve,” Weaver wrote. “It’s unfortunate that Anthem is characterizing a modest, fair and reasonable offer as excessive.”

Additionally, Weaver acknowledged the potential confusion the change may have caused.
“We recognize that some of our patients and physicians have received conflicting or confusing information from Anthem, and we want to ensure that all of our patients’ questions and concerns are addressed so they can continue to receive high-quality care,” she wrote. “It is important to note that physicians’ contracts are remaining in place, so patients do not need to change their physicians or hospitals or interrupt scheduled services. We want to ensure that all of our patients’ questions and concerns are addressed and have therefore posted information on our website.”

MemorialCare has provided a question-and-answer section on its website at memorialcare.org/Anthem-QandA.

Anthem’s letter to its members states that physicians who admit to Long Beach Memorial Medical Center have been notified of the development and will arrange for admissions to alternate facilities.

The company also suggested that its members go to one of its other locations, including St. Mary Medical Center and Lakewood Regional Medical Center.

Anthem Blue Cross members can find more information regarding alternate contracted facilities at anthem.com/ca.

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