Hartford HealthCare sues Anthem over emergency services reimbursement arrangement

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Hartford (Conn.) HealthCare Corp. sued Anthem Blue Cross and Blue Shield over allegations the insurer changed its emergency care reimbursement policies after the two failed to reach a provider agreement last week, according to a Connecticut Law Tribune report.

Hartford HealthCare Corp., which represents six hospitals, filed the lawsuit Thursday in U.S. District Court in Connecticut. The lawsuit alleges Wallingford, Conn.-based Anthem Blue Cross and Blue Shield is violating state and federal law by refusing to pay the hospitals directly for emergency care.

Instead, Anthem is paying patients directly for emergency care, and the patients then have to turn around and pay Hartford HealthCare, according to the allegations. The plaintiff argued its patients "will have the burden of collecting those checks, cashing them and making arrangements to pay Hartford HealthCare themselves. This process is time-consuming and fraught with risk of lost checks, mispayments and other issues." The lawsuit seeks an injunction compelling Anthem to pay the hospitals directly, the report states.

Hartford HealthCare claimed the policy change is Anthem's retaliation for stalled negotiations between the two parties over reimbursement rates. Last week, the hospitals and Anthem failed to negotiate a new provider agreement before a Sept. 30 deadline, resulting in tens of thousands of Anthem members losing in-network access to Hartford HealthCare's facilities.

Anthem did not immediately respond to Becker's Hospital Review's request for comment. Roy Breitenbach, an attorney with Garfunkel Wild in Stamford, Conn., which is representing Hartford HealthCare, did not respond to Connecticut Law Tribune's request for comment.

This article will be updated if more information becomes available.  

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