State says agreement reached in contract dispute between Anthem, St. Joseph Hospital

Paul Feely, The New Hampshire Union Leader, ManchesterNew Hampshire Union Leader

Jan. 24—An agreement has been reached in the contract dispute between St. Joseph Hospital in Nashua and Anthem, New Hampshire's largest health insurance carrier, state insurance officials announced Friday.

The dispute could have led to higher medical bills for tens of thousands of Granite Staters if unresolved by March 1, officials said.

A spokesman for the New Hampshire Insurance Department (NHID) said Insurance Commissioner DJ Bettencourt and senior department officials "engaged intensively with leadership" from both St. Joseph Hospital and Anthem over the past three weeks.

The spokesman said the department was "unable to provide specific details of the agreement."

"Patients seeking more information regarding the terms of the agreement are encouraged to contact St. Joseph Hospital or Anthem directly," the department said.

Bettencourt cited the department's long relationship with Anthem, while saying he appreciates the "collaborative spirit" of St. Joseph Hospital.

Negotiations between the two sides had stalled "primarily due to disagreements over reimbursement rates and alleged payment discrepancies," the Insurance Department said earlier this month.

Anthem Blue Cross and Blue Shield said in a statement they are pleased to have reached an agreement that "provides Anthem members with continued access to care at St. Joseph Hospital and its outpatient care centers and physician offices in southern New Hampshire."

Members with questions can call the number on the back of their Anthem ID card for more information, a spokesperson said.

Anthem said it is unable to share specifics of the deal due to the confidentiality of the agreement.

In a statement, a spokesman for St. Joseph Hospital said it and affiliated outpatient facilities and practices will continue to be an in-network provider for Anthem members.

Patients will continue to have access to the provider(s) they currently see along with the full range of inpatient and outpatient services offered by St. Joseph Hospital, and patients will continue to access care the same way, using the same methods they use today.

"We appreciate the patience Anthem members throughout New Hampshire have shown during this process," said John Jurczyk, FACHE, President, St. Joseph Hospital. "We are confident the extra time we spent in discussions with Anthem New Hampshire helped ensure we continue to provide our patients with the highest quality care and best patient experience possible."

State law requires Anthem to treat its patients at St. Joseph Hospital as in-network until March 1.

Had a resolution not been reached after March 1, "St. Joseph Hospital would be considered out-of-network and ... patients who are covered by Anthem commercial plans may pay higher, out-of-pocket expenses when they receive care at our hospital, outpatient clinics, or provider practices," the hospital said.

Anthem, the state's largest health insurer, previously said the dispute "affects approximately 7,000 Anthem members with individual, employer-based, and Federal Employee Program coverage. Anthem Medicare Advantage members are not affected."

The number included family members covered as well, Anthem said.