HENRICO Co., Va. — Bon Secours has filed a lawsuit against Anthem for $93 million – the amount they claim the insurance giant owes them in unpaid claims in Virginia.
In the lawsuit, which was filed on Monday, August 28, in Henrico County, Bon Secours claims that they’ve been working to resolve the matter with Anthem out of court for nearly four years. Bon Secours further alleges in the suit that in June, Anthem agreed to revisit the issue, but then said there was “insufficient data to respond to the allegations of a breach.”
“As health care providers, we contract with health insurance companies (private payers), including Anthem, to fairly reimburse the ministry for the cost of providing high-quality care to our patients,” said Bon Secours in a statement. “Today, we must share our belief that Anthem owes Bon Secours Mercy Health more than $93 million in outstanding unpaid and underpaid claims in Virginia alone, which significantly impacts our ability to provide sustainable, compassionate, high-quality care for our patients and communities.”
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Bon Secours claims in the suit that they’re not the only medical network in Virginia that’s faced this problem: In April, Valley Health System reached a settlement with Anthem after filing a multi-million-dollar lawsuit, also over unpaid claims.
The legal action against Anthem comes after Bon Secours decided to terminate its contract with Anthem’s Medicare Advantage and Medicaid Managed Care products, the suit states. Bon Secours stopped accepting Anthem’s Medicare Advantage plan August 1, 2023, and they’ll stop accepting Anthem’s Medicaid Managed Care plan on October 1.
Bon Secours states in the lawsuit that the terminations are a result of the “impasse” over the unpaid claims.
Anthem responded to the lawsuit, claiming that it is "another attempt to distract from Bon Secours' decision to leave Anthem’s provider network and deny access to care for Medicaid and Medicare Advantage members. We do not agree with the allegations stated in the lawsuit."
The full statement reads as follows:
This lawsuit is another attempt to distract from Bon Secours' decision to leave Anthem’s provider network and deny access to care for Medicaid and Medicare Advantage members. We do not agree with the allegations stated in the lawsuit.
This is the latest tactic in their efforts to demand double digit price increases from employers and individuals - in the middle of an active contract with Anthem. With these actions, they are closing off opportunities to work collaboratively, despite numerous requests to refocus the discussion and reach a solution.
As recently as last Thursday, we reached out to Mercy Health national leadership for a meeting and Friday to Bon Secours’ Virginia leadership requesting that they rescind the Medicare Advantage termination and intent to terminate Medicaid access on 10/1/23. We have not heard back. We urge Bon Secours to engage in productive discussions instead of these unproductive tactics that continue to spread misinformation and put vulnerable populations at risk.
Stay with News 3 for updates.
