Backus parent company warns Anthem patients of possible lapse

Insurance company has been renegotiating contract expiring Sept.30

Norwich — Patients of The William W. Backus Hospital and other affiliates of Hartford HealthCare who are insured with Anthem Blue Cross and Blue Shield may lose their coverage if a contract between the two companies expires Sept. 30 with no agreement for a new one.

Hartford HealthCare Executive Vice President David A. Whitehead said in a letter to patients late last month that those with commercial, Medicare or Affordable Care Act exchange insurance plans through Anthem may have to pay higher outof-pocket fees after that date if an agreement isn’t reached.

Hartford HealthCare and Anthem for months have been renegotiating a renewal of the three-year contract that expires Sept. 30.

“If we are not able to reach agreement on acceptable renewal terms, HHC hospitals, facilities and providers will no longer participate in Anthem’s networks, effective Oct. 1, 2017,” Anthem spokeswoman Sarah Yeager said in an emailed statement Tuesday. “Anthem has been negotiating in good faith for the past several months in an effort to keep HHC in our network. ... Our goal is to secure an agreement that creates the right balance among access, quality and affordability.”

Other hospitals and facilities in the Hartford HealthCare network include Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center, Windham Community Memorial Hospital, Natchaug Hospital, Rushford Center, Southington Care Center, VNA HealthCare and Jerome Home.

After Sept. 30, if Hartford HealthCare and Anthem don’t reach an agreement, physicians and providers at those facilities no longer will be considered within Anthem’s network, and Anthem-insured patients there will pay higher, out-of-network fees.

Those patients still would receive

care, but would be billed directly by the hospital and then reimbursed by Anthem at outof-network care rates.

Yeager said the parties in these types of negotiations are able to reach an agreement before or soon after the contract expires “in the vast majority of cases.”

In 2014, Anthem and Hartford HealthCare failed to reach an agreement by the Sept. 30 end of their previous contract, over a disagreement that a state Insurance Department official said involved reimbursement rates.

More than 100,000 people covered by Anthem readied themselves to pay higher outof-pocket costs for care at the affected hospitals, including Backus, before the two groups reached a deal two days later, late on Oct. 2.

“Our two organizations continue to meet regularly and our focus remains on renewing our relationship with Anthem,” Hartford HealthCare spokesman Shawn Mawhiney said in an email. “For now, nothing changes and Anthem patients continue to have access to Hartford HealthCare’s services and professionals at in-network rates.”

Patients may eligible for benefits that could help cover their care if their hospital temporarily is removed from Anthem’s network after Sept. 30.

The letter to patients said those who want to learn more should visit Hartford HealthCare’s website at www.hartfordhealthcare.org/anthem, or call a 24-hour toll-free hotline at (800) 644-5905.