Anthem Is Launching A Doctor Blacklist

A new policy by Anthem will punish hospitals that use doctors outside of its network — triggering chaos and cutting patients’ access to care.

By Helen Santoro, The Lever

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 Jan. 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.

The policy will impact plans across 11 states, including Colorado, Georgia, and New Hampshire — all of which are managed by Elevance Health, a multibillion-dollar health company that operates Anthem Blue Cross and Blue Shield plans across 14 states and serves millions of people.