Medical Societies Urge Repeal of New Anthem Out-of-Network Policy
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Over 90 medical societies sent a letter (PDF) this week to Elevance Health President and CEO Gail Boudreaux, urging repeal of a policy that will reduce payment to participating hospitals when out-of-network physicians are used to provide patient care.
Under the Facility Administrative Policy: Use of a Nonparticipating Care Provider (PDF), being rolled out in 11 states starting Jan. 1, 2026, Anthem Blue Cross and Blue Shield plans, under Elevance Health, will begin penalizing hospitals with a 10% reimbursement cut when out-of-network physicians are used in the provision of care, and may be terminating hospitals from Anthem networks for continued use of nonparticipating physicians.
The medical societies expressed concern that the policy essentially circumvents the balance established under the No Surprises Act and highlighted the harm this policy will have on patient access and the stability of independent physician practices. Rather than such a punitive policy, the letter suggests policies that incentivize physician participation in Anthem’s networks such as fair contracts, reduced administrative burdens, prompt payment, and network adequacy requirements.
