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Kim Willis

Norton/Anthem Dispute Settled


By: Health Insurance
Submitted: 2009-10-20 18:23:03 | Word Count: 558


Louisville’s Norton Healthcare and Anthem Blue Cross and Blue Shield insurance company have settled their contract dispute.

The two companies announced in a joint statement today that they have agreed to a new, three-year contract.

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Anthem policyholders have been paying out-of-network rates at most Norton facilities since Norton terminated their contract at the end of June.

Norton officials said they were unhappy with the way Anthem was processing claims and other administrative issues. Anthem officials contended that Norton wanted to raise reimbursement rates to unreasonable levels.

Contract had broken off until last last month, when the two sides returned to the negotiating table.

The agreement, effective today, restores in-network access to Norton’s five hospitals and other facilities for Anthem customers. Anthem has some 300,000 policyholders in the Louisville area.

Norton and Anthem officials have declined interviews about the agreement, but say in the statement they’re satisfied with the new contract.

Here is the joint statement from Norton and Anthem:

Norton Healthcare, Anthem Agree to New Three-Year Contract

LOUISVILLE, KY.: Norton Healthcare and Anthem Blue Cross and Blue Shield in Kentucky
have agreed to a new three-year contract, effective today. The contract restores in-network
access to Norton facilities and providers for Anthem policyholders and employer groups.

The previous contract expired June 30, 2009. The new agreement covers Norton Healthcare’s
five hospitals and related services, including:

? Kosair Children’s Hospital, Norton Audubon Hospital, Norton Brownsboro Hospital,
Norton Hospital and Norton Suburban Hospital;

? Norton’s 14 outpatient centers and more than 300 employed primary-care and
specialty-care physicians located throughout Metro Louisville and Southern Indiana.

Anthem members enrolled in Blue Access/Access (PPO), Blue Preferred/Preferred (HMO), Blue
Traditional/Traditional, Medicare Advantage HMO/PPO, Medicare Select and Kentucky Access may again receive covered services at Norton facilities and from Norton-employed physicians, diagnostic centers and immediate care facilities with the highest level of benefits and lowest out-of-pocket cost.

“We recognize how difficult the out-of-network situation has been for our Anthem patients, physicians, employers, insurance brokers and others directly affected,” said Stephen A. Williams, president & CEO, Norton Healthcare. “But this new three-year agreement allows us to achieve our not-for-profit mission of providing all of our patients with timely, in-network access to our comprehensive range of adult and pediatric health care services. We are very pleased with what we consider to be a fair agreement.”

“Over the past several weeks, we have had several meetings involving serious and intense negotiations, and I am satisfied that we have successfully resolved this matter,” said Deb Moessner, president & general manager, Anthem Blue Cross and Blue Shield in Kentucky.

“I strongly believe that we have ultimately reached a fair agreement that meets the need of our community and our members. I am very pleased with the outcome.”

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