Anthem Is Cutting Access to Out-of-Network Doctors
Health insurance giant Anthem is introducing a new policy that will penalize hospitals for using physicians outside of its coverage network, forcing medical facilities to police physicians’ network status and decrease care options for patients.
Anthem’s new policy may leave hospitals and patients scrambling for care. (Raquel Natalicchio / Houston Chronicle via Getty Images)
A new policy by the health insurer Anthem will penalize hospitals for using doctors outside of its coverage network.
Anthem claims the move is designed to reduce its members’ out-of-pocket costs. But critics argue it will force medical facilities to police physicians’ network status, strong-arm doctors into accepting lower payments from health insurance companies, and could lead to fewer care options for patients.
According to the new policy, which will take effect on January 1, Anthem will cut a hospital’s reimbursements by 10 percent whenever the facility submits a claim that includes services from out-of-network providers. Additionally, hospitals that rely on out-of-network service providers will risk “potential termination from Anthem’s networks,” according to Anthem’s notice.
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