Patients insured by Anthem could face higher charges at Backus

Anthem Blue Cross and Blue Shield, the state’s largest health insurer, has failed to reach an agreement over reimbursement rates with Hartford HealthCare’s five hospitals, including The William W. Backus Hospital in Norwich.

Sarah Yeager, spokeswoman for Anthem, said Wednesday that the insurer notified insurance brokers Aug. 4 that because of the lack of an agreement, patients with Anthem who seek care at any of the five hospitals will be out of network on Oct. 1, meaning they would face higher costs or have to seek care elsewhere. Other hospitals in the network include Hartford Hospital, the Hospital of Central Connecticut in New Britain, MidState Medical Center in Meridan and Windham Community Memorial Hospital.

Negotiations are continuing, she said.

“Typically agreements are reached,” she said.

Hartford HealthCare spokeswoman Tina Varona said late Wednesday afternoon that the hospital network is “fully committed to negotiate and resolve in good faith a contract with Anthem BlueCross and BlueShield that will allow us to be paid fairly for the services we provide our patients.”

She said that while specifics of the negotiations are confidential, Hartford HealthCare has not requested a double-digit increase in reimbursement rates, but “a lower percentage for a one-year renewal term.”

The negotiations include discussions about hospital and physician rates, definitions of services, and value-based purchasing criteria, she said.

“We remain hopeful that we will come to an agreement on the negotiations process prior to the contract deadline on Sept. 30,” she said.

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