Cincinnati-based Bon Secours Mercy Health and Anthem Blue Cross and Blue Shield have reached a contract agreement through 2028, ending one of the more public payer-provider reimbursement disputes of this year, per Becker’s.
The new agreement applies to all Bon Secours Mercy Health hospitals, outpatient care centers, and physician offices in Ohio, Virginia, and Kentucky for Anthem Medicare Advantage, Medicaid, employer-sponsored and exchange members.
Anthem has also agreed to cover any claims that patients may have submitted when the two organizations were out of network, including Anthem Medicare Advantage plans in Virginia and Anthem Medicaid in Ohio.
In August, Anthem Virginia filed a cease and desist order against Bon Secours, alleging the system was improperly denying access to care to Medicaid beneficiaries. Later that month, Bon Secours sued Anthem Virginia, alleging the payer owed $93 million in unpaid claims. The lawsuit is being dismissed with the new contract agreement in place.
