The Northside Hospital system and Anthem Blue Cross and Blue Shield in Georgia today announced they have finalized a new agreement that provides access to care at Northside for Anthem Blue Cross and Blue Shield’s members.
“Northside Hospital has an unwavering focus on patients and their families, and that always is our mission,” said Scott Wade, vice president of Northside Hospital. “The outcome of our discussions is great news for our partnership with Anthem Blue Cross and Blue Shield and our patients.”
Northside Hospital and Anthem Blue Cross and Blue Shield in Georgia have enjoyed a partnership for more than 30 years. The successful resolution of these discussions represents a commitment to further strengthening a partnership that potentially will develop into a model for the Atlanta region and all of Georgia.
“I’m pleased we were able to come to a resolution on behalf of our members. Our new agreement with Northside continues and enhances our partnership, continuing access to quality care for Georgians, which is our focus,” said Robert Bunch, president of Anthem Blue Cross and Blue Shield in Georgia. “I want to thank Northside’s Bob Quattrocchi and Scott Wade for their partnership and efforts to find common ground.”
The new agreement is effective immediately, meaning Anthem Blue Cross and Blue Shield members will have in-network access to Northside’s hospitals, physicians, and other outpatient locations in Georgia for the foreseeable future.
Northside's Anthem patients to stay in network indefinitely
APRIL 13, 2022 – Today, the Fulton County Superior Court issued its latest ruling in the ongoing business dispute between Northside Hospital and Anthem Blue Cross Blue Shield of Georgia.
Judge Rachelle L. Carnesale, who in late January extended an injunction to ensure health care coverage for hundreds of thousands of Anthem patients, has further extended the injunction in her ruling today. The extension has no specific termination date, so Anthem patients can continue to receive their medical care in the Northside Hospital system on an in-network basis beyond April 15.
Judge Carnesale also ruled that the Northside-Anthem matter should now be referred to the Georgia Department of Insurance to determine if Anthem’s current attempt to separate patients from their trusted health care providers is permissible.
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.
Court grants Northside Hospital a major extension that keeps Anthem patients in network
JANUARY 28, 2022 – A judge has extended an injunction that ensures thousands of Georgians will continue to receive health care from their current physicians and preferred hospitals.
This most recent 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 through April 15, 2022.
In a court hearing on January 26, Anthem sought to end the 30-day injunction and initiate an immediate termination of health care coverage for Northside patients. Today, a judge denied Anthem’s request and granted the extension to Northside.
Other stakeholders in the Atlanta region – including Cherokee, Forsyth, and Gwinnett counties – provided support through their own court filings or letters of concern. Tens of thousands of their government employees and local teachers are Anthem members, and they would be adversely affected if a termination had occurred.
While the injunction extension keeps Northside’s Anthem patients in network, Northside and Anthem remain in negotiations as they try to work out new agreements.
Northside’s agreements with Anthem were not up for renewal and were not set to expire. Still, 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.
In its original court filings in late 2021, 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. It prevents insurance companies from terminating health care providers during a public health emergency, such as COVID-19.
Northside has worked diligently to resolve this situation and is acutely aware of the stress and frustration of Anthem members and their families. Northside will continue its discussions with Anthem, with the intention of reaching an agreement that provides the best benefits to patients and their families.
If You Have Questions
We have resources available to you now at northside.com. We encourage you to visit Billing and Collections, where you will find guidance and many resources. You also can email customer.service@northside.com or call 404-851-6500.
To learn more about Northside Hospital’s Financial Assistance Program, you can download the Northside Hospital Financial Assistance Program Policy and Financial Assistance Application or you may contact our Financial Counseling offices to request that a copy of these documents be mailed to you. If you are an oncology patient, the Financial Assistance Application for Oncology can be found here.
Georgia Health News
Anthem names new chief in Georgia amid dispute with Northside
JANUARY 23, 2022 – ...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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