Anthem-Blue Cross Dispute Referred To Georgia Insurance Department

A Fulton County court has ruled Anthem Blue Cross Blue Shield patients are to remain in-network for Northside Hospital doctors and facilities indefinitely, until the state Department of Insurance reviews the ongoing Northside-Anthem dispute.

Recently, Fulton County Superior Court Judge Rachelle Carnesale extended an injunction keeping Anthem patients in-network, without a specific termination date.The previous court order extended coverage through April 15.

Carnesale also ruled that the Northside-Anthem dispute should be referred to the Georgia Department of Insurance.

The dispute began late last year, when Anthem began the process of ending coverage of Northside Hospital physicians and facilities, and alerted consumers that Northside may not be part of its network by Jan. 1. The Fulton County Superior Court ordered an injunction that so far has kept patients in-network.

Northside has argued that Georgia law prevents insurers from ending coverage during a public health emergency such as COVID-19. The hos- pital system estimates there are over 400,000 Anthem patients who would be left out of network if the court order is stopped.

“Northside has diligently pursued legal remedies in this dispute because of its critical importance to protecting the rights of hundreds of thousands of Georgians. Northside will continue to provide updates to its patients and their families as they develop,” the hospital system said in a press release.

Anthem has said it has sought to end its current contract with Northside Hospital to save money for its customers.

“Ensuring access to care is why we began negotiations early and have been working in good faith for a year to reach a new agreement with Northside, one that provides affordability, greater quality, and pro- motes health equity. Unfortunately, continuing to operate under the current contract will not achieve the affordability or quality improvements we have been seeking, and that our members deserve,” Anthem spokesperson Denise Ward said in a statement Thursday. “We have been engaged in regular discussions with Northside on a new contract. We now ask Northside to join us in bringing to an end this year-long negotiation by ?nalizing an agreement that is in the best interests of consumers.”

According to Anthem, the contract dispute affects both individual and employer-based insurance. Medicaid is under a separate contract, so Medicaid customers are not affected.

Cherokee County, which uses Anthem as the administrator of its employee health plan, joined Northside in the suit.