Cincinnati-based Bon Secours Mercy Health is suing Anthem Blue Cross Blue Shield of Virginia for $93 million, alleging the payer owes the health system millions in unpaid claims, according to a lawsuit filed yesterday in a Virginia circuit court.
The lawsuit comes in the midst of a dispute over reimbursement rates between the two organizations. BSMH wrote on its website, “By failing to reach an equitable agreement with us, Anthem may be putting your in-network access to the Bon Secours facilities and providers you know and trust at risk.”
A spokesperson for the health system previously told Becker’s it is seeking higher reimbursement rates from all Anthem plans besides Medicaid.
Since Aug. 1, nearly 50,000 Anthem Medicaid beneficiaries in Ohio and 11,000 Anthem Medicare Advantage members in Virginia have been out of network with Bon Secours Mercy facilities. Anthem’s Medicaid plan in Virginia and Medicare Advantage members in Ohio and Kentucky will be out of network with a majority of BSMH facilities by October, Becker’s reports.
The suit was filed less than a week after Anthem slapped Bon Secours Mercy Health with a cease-and-desist order for allegedly denying access to Anthem’s Medicaid patients amid the tense reimbursement rate dispute. Read more.
