Indiana health system's contract with Anthem set to expire amid tensions over ER policy

An in-network contract between Mishawaka, Ind.-based Saint Joseph Health System and Anthem is slated to expire June 30 unless the organizations can negotiate a new agreement, according to the South Bend Tribune.

In a recent letter to patients, Saint Joseph Health System warned Anthem members with commercial, Medicaid or Medicare Advantage coverage that they could face out-of-network costs for treatment should the contract expire without resolution. The two organizations already disagreed over Anthem's discretionary emergency room coverage policy it recently rolled out in Indiana.

Under the policy, Anthem may not cover ER visits it deems unnecessary for policyholders. The policy aims to steer Anthem members with nonemergent ailments toward a primary care physician or an urgent care provider instead of costly and overcrowded ERs. Saint Joseph Health System CEO Chad Towner previously called the policy "objectionable" and "potentially harmful" in a separate letter obtained by the South Bend Tribune.

In an emailed statement to the publication on the state of negotiations, Mr. Towner said the health system is in "good faith discussions to continue our longstanding relationship with Anthem."

Anthem spokesperson Tony Felts told the South Bend Tribune the insurer is "committed to keeping consumers informed about the status of our negotiations."

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