An in-network contract tying Atlanta-based Piedmont Healthcare to Anthem Blue Cross Blue Shield's provider network expired March 31, affecting hundreds of thousands of patients.
Here are four things to know about the contract lapse.
1. As of April 1, Anthem BCBS members must pay higher out-of-pocket costs to receive physician and hospital services at Piedmont. The change doesn't affect Medicare Advantage plan holders, save for Covington, Ga.-based Piedmont Newton Hospital patients.
2. "We are disappointed that we have been unable to reach an agreement with Anthem Blue Cross for a renewed contract. We believed that both parties were negotiating in good-faith and had planned to reach an agreement by March 31," according to a Piedmont statement. "It didn't become clear to us that Anthem Blue Cross didn't share that goal until the end of negotiations. We were particularly disappointed that the written contracts from Anthem Blue Cross did not reflect the progress we thought we were making in our verbal conversations."
3. Piedmont argued Anthem BCBS failed to offer its physicians a rate that would cover the annual rate of inflation, and jabbed a finger at the insurer for telling patients Piedmont's rate requests were too high.
4. Anthem BCBS told Becker's Hospital Review, "Despite our ongoing efforts, Blue Cross and Blue Shield of Georgia has been unable to reach a new agreement with Piedmont Healthcare that will keep them in our network of healthcare providers beginning on April 1.
"We apologize to our consumers for any disruption this may cause and we are working hard to reach an agreement with Piedmont as quickly as possible. Our priority is to protect our consumers and ensure that they continue to have access to affordable healthcare through the Piedmont network."