Northside Hospital Forsyth recently issued the following announcement.
The most recent step in the legal battle involves a motion from Cherokee County, filed last week, to intervene in the matter as an added plaintiff backing Northside’s position. Cherokee, in the northern suburbs of Atlanta, noted that Northside operates the only hospital in the county.
“When Cherokee County contracted with Anthem to serve as the administrator of Cherokee County’s employee health plan, it never imagined that Anthem would one day exclude the only acute care hospital and countless other indispensable (and irreplaceable) health care providers in the county from its network,’’ the motion says.
The five-hospital Northside system has pointed out that the legal battle comes during the fifth surge of Covid-19 cases and hospitalizations, driven by the highly contagious Omicron variant...
Read the full story at GeorgiaHealthNews.com.
Anthem seeks to force health insurance termination of Northside Hospital patients
Challenges court decision and requests injunction dismissal
JANUARY 11, 2022 – Anthem has filed for an emergency motion to terminate the temporary restraining order that is keeping Anthem patients in-network with their physicians and with Northside health care facilities.
If Anthem’s request is allowed, more than 400,000 Anthem patients will be immediately separated from their Northside doctors and be out-of-network for Northside hospitals, clinics, and physician practices – all while the COVID-19 winter surge continues with the highest levels of cases yet seen.
On January 11, Northside had more than 600 COVID-19 patients in its Atlanta area facilities, representing nearly half of its inpatient bed capacity.
On December 30, 2021, Northside Hospital was granted an injunction by the Superior Court. The injunction temporarily (until January 31, 2022) stops a threatened termination of health care coverage by Anthem Blue Cross Blue Shield. However, Anthem is still attempting to force patients out of the Northside network even earlier.
For now, the court decision enables Anthem members who seek care at Northside’s hospitals, clinics, and physician practices to remain fully covered and in-network while the parties work towards a long-term resolution.
In its court filings, Northside cited a Georgia law that went into effect July 1, 2021. House Bill 454 was approved by both houses of the Georgia General Assembly and signed by Gov. Brian Kemp. Specifically, the law states in part:
“In the event of a public health emergency…..an insurer shall, for a period commencing on the effective date of the public health emergency and ending 150 days after the expiration of such public health emergency…..be prohibited from terminating a provider from the insurer’s network…..”
As the Superior Court ruled, a public health emergency clearly exists.
The injunction issued by the courts is a temporary measure to ensure Anthem patients can still access care within the Northside Healthcare System. In the meantime, Northside is attempting to continue its discussions with Anthem, with the intention of reaching a long-term agreement that provides the best benefits to patients and their families. We urge all Anthem members to contact Anthem to voice their concern with this behavior.
Northside Hospital patients will remain in-network with Anthem Blue Cross Blue Shield
Court stops Anthem’s termination threats
DECEMBER 30, 2021 – In a major victory for hundreds of thousands of Georgians, Northside Hospital has been granted injunctive relief by the court that temporarily stops a threatened termination of health care coverage by Anthem Blue Cross Blue Shield.
The decision by the Superior Court of Fulton County enables Anthem members who seek care at Northside’s hospitals, clinics, and physician practices to remain fully covered and in-network while the parties work towards a long-term resolution.
In its court filings, Northside cited a Georgia law that went into effect July 1, 2021. House Bill 454 was approved by both houses of the Georgia General Assembly and signed by Gov. Brian Kemp. Specifically, the law states in part:
“In the event of a public health emergency…..an insurer shall, for a period commencing on the effective date of the public health emergency and ending 150 days after the expiration of such public health emergency…..be prohibited from terminating a provider from the insurer’s network…..”
Why did Northside take this action?
Our agreements with Anthem were not up for renewal and were not set to expire. Still, earlier this year, Anthem began a process that would separate hundreds of thousands of Georgians from their doctors and health care resources by unilaterally and without cause terminating the existing agreements. And with the COVID-19 Omicron variant now surging through U.S. and Georgia, Anthem’s decision to remove Northside from its networks defied both logic and sensitivity.
What does this mean for Anthem members?
It means that Anthem members can continue to receive health care services at any Northside location or physician practice on an in-network basis after January 1. The injunction issued by the courts is a temporary measure to ensure Anthem patients can still access care within the Northside Healthcare System. In the meantime, Northside will continue its discussions with Anthem, with the intention of reaching a long-term agreement that provides the best benefits to patients and their families.
We encourage Northside patients to continue to share their concerns with Anthem -- to ensure that their rights to choose their physicians and hospitals are protected.
Original source can be found here.
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