The two companies failed to finalize an agreement by Friday’s deadline despite several months of talks.
MAINE, USA — Northern Light Health patients enrolled with Anthem insurance will keep receiving in-network billing rates as discussions for a new contract continue, even after missing a crucial deadline last Friday.
In an announcement made early Saturday, Dr. R. Guy Hudson, the president and CEO of Northern Light, confirmed that they haven’t come to an agreement yet but assured that patient care will remain uninterrupted.
“As of this morning, we do not have a new contract with Anthem,” Hudson stated. “I want to reassure Anthem’s patients that they can keep getting care from Northern Light Health without any interruptions during these negotiations. They will not be considered out-of-network. We’re committed to their health and are working towards a contract that ensures they receive the necessary services.”
The two parties have been discussing reimbursement rates for quite some time, but progress has been minimal. Although the original contract was set to expire on October 1st, the deadline was pushed to Friday, October 31st. If an agreement isn’t reached, Northern Light’s primary care providers, specialists, and outpatient services would exit Anthem’s network, which serves around 30,000 customers.
State officials pointed out that Maine has specific legal protections for situations like this. Maine’s insurance legislation mandates that health plans must ensure “reasonable access” to healthcare, although it doesn’t specify what that entails. Rules regarding continuity of care allow patients who have ongoing treatments to maintain their relationship with providers even if they go out of network, thus avoiding high costs.
“You won’t have to find another OB/GYN,” remarked Bob Carey, director of the Maine Department of Health. “For instance, if you’re close to giving birth or in the midst of cancer therapy, you can continue your treatment without interruptions.”
This missed deadline particularly impacts Northern Light employees using Anthem for individual or employer-sponsored plans, which cover outpatient services like annual exams. However, Anthem Medicare coverage for Northern Light patients is valid through the end of the year, and emergency services will consistently remain in-network under federal regulations.
Looking ahead, another significant deadline looms on December 31st, after which Northern Light Hospital and its inpatient services will no longer be part of the network if an agreement isn’t reached. Carey noted that any patients admitted to Northern Light Hospital will still be covered at in-network rates while they are being treated there.
Anthem has set up a dedicated website providing updated information and guidance for its customers. The Maine Department of Insurance recommends that patients contact the number printed on their insurance card to confirm their coverage and costs before seeing a Northern Light provider.
