Anthem is calling Northern Light Health’s pledge to treat the insurer’s customers as in network a “recipe for patient confusion.”
That comes just days after the state’s largest private health insurer and second-largest hospital network again failed to reach a new contract to keep Northern Light within Anthem’s network.
After Friday’s deadline to reach a contract expired, Northern Light said it would continue to treat Anthem’s customers as though the system was still within the insurer’s network. But unlike the previous deadline to reach a contract, Northern Light and Anthem haven’t yet signed a contract extension.
But in a Monday morning statement, Anthem said that Northern Light moved out of its network Saturday, except for its hospitals and for Medicare Advantage customers, which remain within network until Dec. 31.
Unless Northern Light agrees to a contract extension, Anthem said that it will process claims for non-hospital services as out of network.
“Northern Light Health saying they will treat patients as in-network – with no plan or agreement to do so – is a recipe for patient confusion, incorrect charges to patients, and other complications,” Anthem said in a statement.
Anthem said that it is willing to sign a contract extension as soon as possible.
The dispute between Brewer-based Northern Light Health and the state’s largest private health insurer went public months ago as they came to loggerheads over a new contract.
Northern Light broke off contract negotiations with Anthem in mid-August. In severing negotiations, Northern Light said it sent Anthem a counteroffer on July 30, but the insurer declined to submit a response. The system came back later that month as both sides entered mediation.
But since then, they have feuded publicly, with each side accusing the other of being inflexible or making unreasonable demands at the bargaining table.
On Monday, Anthem said that Northern Light’s latest proposal “continues to exceed what we can ask our members and employer customers to pay.”
“We are focused on having Northern Light Health in our network at prices our members and employers can afford,” Anthem said in a statement.
In 2022, a contract dispute between MaineHealth and Anthem played out in public, with the health system accusing the insurer of owing millions in back payments and holding up and disputing millions more in payments, while Anthem accused MaineHealth of millions in overcharges.
Before the contract expired, both sides reached a deal, preventing MaineHealth from withdrawing from Anthem’s network.
More cuts and service changes are coming to Northern Light in the coming months.
The financial turmoil gripping Northern Light may be compounded by federal Medicaid cuts and a state law expanding charity care.
