Northern Light Health announced Friday that it is ending contract negotiations with Anthem Blue Cross and Blue Shield, the state’s largest insurer.
Starting Oct. 1, Northern Light services will now be out of network for people insured by Anthem, the Brewer-based health system said.
Contract talks between Northern Light, one of the largest health care providers in Maine, and Anthem have been messy and public in recent months with each accusing the other of jeopardizing the relationship at the expense of patients.
On Friday, Northern Light blamed Anthem’s “decision to withhold interim payments for services provided and a cumbersome prior authorization process” that led to unnecessary trouble caring for patients at Northern Light facilities.
Recently, Northern Light said its contract with Anthem would expire on Sept. 30 if the insurer didn’t agree to raise reimbursement rates.
Anthem has said Northern Light Health wanted a 30 percent price increase over three years.
“In the event that Anthem comes back with a reasonable offer, Northern Light will consider that,” the system said on Friday. “The time has arrived, though, where Northern Light Health cannot stand passively awaiting a constructive proposal when there is no indication of a desire to that end on the part of Anthem.”
Northern Light sent Anthem a counter offer July 30 as part of negotiations, and the insurance company said this week it would not return another offer in response, according to James Rohrbaugh, Northern Light’s Chief Financial Officer.
“We haven’t seen any indication from Anthem of a commitment to the things that are important to our mission as an organization, and so we don’t have a line of sight to believing that there is a solution,” Rohrbaugh said.
Jim Turner, a spokesperson for Anthem Blue Cross and Blue Shield, on Friday said Anthem is disappointed at Northern Light’s decision to cut off talks before the end of the contract but said the insurer maintains hope that an agreement can still be reached.
“It’s the right thing to do for our members who are Northern Light patients. So, we intend to keep the lines of communication open,” Turner said.
In 2022, a contract dispute between MaineHealth and Anthem played out in public, with the health system accusing the insurer of owing millions in back payments and holding up and disputing millions more in payments, while Anthem accused MaineHealth of millions in overcharges.
Before the contract expired, both sides reached a deal, preventing MaineHealth from withdrawing from Anthem’s network.
BDN writer Annie Rupertus contributed reporting.
