Editor's Note: The story has been modified to show Elevance Health as the parent company Anthem Blue Cross and Blue Shield in Ohio.

A battle between Mercy Health and the insurance Anthem is facing a fast-approaching deadline, and it may be patients who are hurt in the battle.

According to a press release by Mercy Health, the issue between Bon Secours Mercy Health and Elevance Health, the parent company of Anthem Blue Cross and Blue Shield as it is known in Ohio, started over reimbursement from the insurance provider more than nine months ago. Anthem only began offering its managed Medicaid services in Ohio in February. 

The statement from the healthcare provider claims that claims for payment through the insurance company have not kept pace with the rising cost of labor, supplies, and drugs. 

21 News reached out to find out what this means for anyone needing to go to Mercy Health and how it could impact Anthem card holders or Medicaid recipients after June 30 when the contract expires.

Those who may be impacted will be anyone Anthem's Managed Medicaid health plan. On July 1, if an agreement isn't reached, which would mean that anyone using their Elevance insurance at a Mercy Health facility will incur out-of-network additional fee for services.

Who will be impacted if an agreement isn't reached?

Mercy: Patients in Ohio with Anthem Managed Medicaid health plan. Other patients with Anthem insurance are not impacted now but, according to a written response from Mercy,  could be impacted soon. 

Antham: Anthem said it began providing access to healthcare and support services to Ohio Medicaid Managed Care for Medicaid-eligible people this February, aiming to provide access to high-quality care while also considering costs.

To read Mercy's statement, click here.

To read Athem (Elevance) statement, click here.

Lisa Lawless. the Deputy Director, Chief Communications Officer for Ohio Department of Medicaid told 21 News, "For background, it’s important to understand that managed care plans have network requirements to make specific services and practices available and accessible to members as measured by drive time and county of residence.

Medicaid-managed care plans have authority and responsibility to negotiate with providers and health systems to meet and maintain their network requirements.

Ohio Department of Medicaid prefers plans and providers negotiate contracting arrangements and rates independent of the department.

Lawless added that Ohio Medicaid is aware of the ongoing negotiations between the two entities and "will continue to work closely with each health plan to ensure every Ohioan served by Medicaid has access to the healthcare services and supports they need.'

 

Earlier this year, Anthem began providing access to healthcare and support services to further the Next Generation of Ohio Medicaid Managed Care for Medicaid-eligible people. As a new Medicaid managed care organization in Ohio, our goal is to provide access to high-quality care while also considering costs to help make sure our members get the best results.

Focus on providing low-cost, quality care

Anthem said in a written statement it "is working to reach an agreement to provide our Medicaid members with continued access to low-cost care at Mercy Health. Our current agreement is in place through June 30, 2023. Mercy Health is in our Medicaid members’ network until that date. We will keep working hard and in good faith to make an agreement focused on delivering quality access to care for those we serve."

But Anthem said that if an agreement can’t be reached, Mercy Health will no longer be in its Medicaid members’ network effective July 1, noting it applies to all Mercy Health facilities throughout Ohio.

It was noted that Anthem Medicare Advantage as well as Anthem individual and employer-based plans are not impacted at this time by both Mercy and Anthem.