Mercy Health and Anthem have still yet to reach an agreement as patients with the deadline for Anthem Blue Cross and Blue Shield patients to lose their coverage from Mercy Health providers still looming.

Earlier in the summer, it was announced that Mercy Health was cutting ties with Anthem meaning Medicaid patients with Anthem Blue Cross Blue Shield were no longer in network with Mercy Health.

Now, Anthem Medicare Advantage patients are being told that their coverage with Mercy will end on October 1 if an agreement is not reached by then.

21 News reached out to both Mercy Health and Anthem for an update on where talks stand and what these affected patients can do should they lose their coverage with Mercy Health.

Anthem Director of Public Relations, Jeff Blunt tells 21 News that Anthem remains hopeful that it will reach an agreement with Mercy before the October deadline.

In the meantime, Blunt says Anthem is working to assist members to transition elective care to one of many other systems in its network, as well as assist members who require continued care with their current providers for certain conditions.

"Mercy Health terminated these Medicaid and Medicare Advantage contracts early as a negotiating tactic to raise costs for Anthem members covered by employer-sponsored and Affordable Care Act plans. Mercy Health is needlessly disrupting care for thousands of vulnerable people," Blunt said in a statement.

Mercy Health responded to this claim by stating that Anthem owes more unpaid claims Ohio and Kentucky than in Virginia, all stemming from "no-pay and slow-pay" tactics outlined in a lawsuit filed against Anthem in the Circuit Court of Henrico County

Mercy added that Anthem refuses to pay for over $100 million in services that have already been provided to patients covered under their plans with this number continuing to rise.  Anthem Ohio's Medicaid president says that simply isn't true

"They allege roughly $93 Million in late claims but that is not based on actual claims data and when we've asked Mercy they've refused to share any actionable or supporting data to justify that number.", said Greg LaManna.

 Mercy Health disputing that claim with this statement;

"Mercy Health has provided documentation around late and unpaid claims to Anthem and has also asked numerous times to have our senior leaders meet and yet, these requests have been ignored. We cannot reach an agreement if Anthem refuses to participate in negotiations. Statements by Anthem claiming otherwise are an attempt to distract from the facts, which includes those outlined in a 25-page lawsuit Bon Secours Mercy Health (BSMH) filed in federal court in Virginia. As noted in the lawsuit, BSMH Virginia has worked for nearly four years to resolve this issue since it was first identified in October 2019. The organization has engaged with Anthem via dozens of letters, meetings and formal notices, none of which have yielded results of any kind. In fact, since this issue was uncovered and shared with Anthem, BSMH Virginia has seen a significant increase in the frequency and magnitude of Anthem’s denial practice. Denials are up more than 20% since March and audits rose 165% in June, which creates enormous administrative burdens that take away from patient care. As shared before, Anthem owes BSMH more in unpaid claims in Ohio and Kentucky than it does in Virginia, which all stem from the same no-pay and slow-pay tactics outlined in the suit. It is imperative that Anthem step up and support the care and well-being of its policyholders and the health care providers who care for them. We are doing our part to serve our patients and communities, and we need Anthem to do theirs by offering sustainable, market-equitable rates and fair contract terms to ensure health care is available for Mercy Health patients well into the future."

Additionally Mercy Health says they understands that this change can be overwhelming for patients, so the company is working to help affected patients evaluate their options. 

Patients are encouraged to talk to their broker or call the Centers for Medicare and Medicaid Services at 800-633-4227 to explore their options. Medicare open enrollment begins on October 15.

"Mercy Health believes every patient deserves access to high quality care and the providers they know and trust. Thousands of patients across Mercy Health's footprint have already switched insurers to maintain access to their trusted providers," the statement reads.

Both sides are hopeful that a deal can get done