Fishersville, Va.-based Augusta Health went out of network with Anthem nearly five months ago. Now, the hospital said Anthem is attempting to strong-arm two private physician practices into a contract to get the hospital back in network, the News Leader reports.
Here are five things to know about the dispute.
1. Augusta Health President and CEO Mary Mannix sent a letter to physician colleagues assuring them the hospital didn't agree to Anthem's terms, and would not link its negotiations with private practice affiliates.
2. "It is our position that this request would be a coercive tactic, would greatly weaken the negotiating position of private practices, is lacking in ethics, and is inconsistent with our principles of corporate integrity," Ms. Mannix's letter, obtained by the News Leader, reads. "This is a tactic intended to drive a wedge been the hospital and the medical community."
3. Augusta Health and Anthem are still negotiating parts of their contract after a previous agreement between the hospital and insurer expired Dec. 31, 2017. Another contract between Augusta Medical Group and Anthem expired Jan. 31, 2018.
4. Several sticking points are delaying resolution. Augusta Health said it won't agree to Anthem's move to not reimburse the hospital for a 30-day readmission and only pay for 24 hours of observation regardless of how long a patient stays. The report states Anthem also seeks a reduction in hospital diagnosis-related group payment by 50 percent for short visits.
5. Becker's Hospital Review reached out to Anthem for comment on the letter and its ongoing negotiations with Augusta Health. This article will be updated once more information becomes available.
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