MAINE, USA — Northern Light Health, one of Maine’s largest health care systems, warned patients Wednesday that contract negotiations with insurance provider Anthem have stalled.
The current contract is set to expire on Sept. 30, according to a news release from the health system.
Northern Light said it has notified Anthem that the agreement will end unless a new contract with “adequate reimbursement” is reached. If that happens, it could leave patients out-of-network.
Northern Light cited Anthem’s reimbursement rates, which it says have not kept pace with rising health care costs, as the main reason for the stalled talks.
“For years, Anthem has cited rising costs of care to justify increasing the premiums paid by their customers, while our reimbursements from Anthem have seen an average annual increase of less than 1.5%.” Executive Vice President and Chief Financial Officer James Rohrbaugh said in the release. “The annual inflation rate for health services has averaged more than 7.5%.”
Low reimbursement rates in general have been cited for hospital and department closures across the state, including the recent closure of Northern Light Inland Hospital in Waterville.
In a statement to NEWS CENTER Maine, Anthem said it has “offered reasonable payment rate increases that are higher than the inflation rate and would align with other Maine health systems.”
The company claims Northern Light is seeking to raise its prices for Anthem patients by 30 percent over the next three years, which could increase health care costs by $218 million.
Although the contract is set to end in September, Anthem noted it includes a required 90-day extension to allow for continued negotiations.
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