Elevance Health Defends Out-of-Network Care Policy

Elevance Health, the parent company of Anthem, responded to a recent AMA sign-on letter regarding a controversial policy the insurer is implementing Jan. 1. The policy will impose payment penalties on in-network hospitals that allow non-emergent care to be performed by out-of-network providers.

ACR® signed onto the AMA letter, joined the American College of Emergency Physicians and the American Society of Anesthesiologists in a separate letter, and met with Elevance in November. The societies suggested that the best course of action is for the insurer to work with providers on fair contracts that would benefit all parties, including and especially patients. Despite the letters and meeting, the insurer is holding firm on its policy position. Elevance asserts the policy will ensure patient access to in-network clinicians for non-emergency care at in-network hospitals and reduce healthcare costs by curbing “misuse” of the federal No Surprises Act Independent Dispute Resolution process.

For more information, contact Katie Keysor, ACR Senior Director of Economics and Health Policy.