"The California Hospital Association filed a lawsuit against Anthem, challenging the payer's 'network penalty policy,' which decreases payments to hospitals by 10% when out-of-network physicians treat patients."
"The association argues that these payment reductions go beyond normal out-of-network reimbursement rules and hurt hospitals' ability to cover the cost of care."
"Daron Tooch, the association's legal counsel, stated, 'We are confident the courts will recognize Anthem's move as a flagrant attempt to increase their profits at a time when millions of Californians are projected to lose their health care coverage.'"
"The lawsuit seeks to block the policy and recover payments that hospitals say were improperly cut, as well as a declaration that Anthem's approach violates state reimbursement requirements."
Healthcare providers are turning to the legal system to address perceived unfair payment practices by insurers. The California Hospital Association has filed a lawsuit against Anthem, challenging its network penalty policy that reduces payments to hospitals when out-of-network physicians treat patients. This policy is claimed to harm hospitals' financial stability and pressure them into accepting lower in-network rates. The lawsuit seeks to block the policy and recover improperly cut payments, asserting that it violates state reimbursement requirements.
Read at MedCity News
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