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Agreement deadline nears for Mercy, Anthem Medicaid deal

YOUNGSTOWN — Bon Secours Mercy Health and Anthem Blue Cross and Blue Shield have not reached an agreement on rates, and with Saturday’s deadline looming, nearly 50,000 Ohioans, including 3,541 in the Mahoning Valley, could lose their Medicaid insurance coverage with Mercy Health.

Mercy Health spokeswoman Kara Franz said by email Thursday that Anthem recently rescinded its most recent offer and discontinued rate negotiations, which have been ongoing for nine months.

“We want to be good stewards of your health care dollar,” Franz said via email. “In a recent Modern Healthcare article, it was noted that Anthem reported earnings of $2.8B in the first quarter of this year alone — a 16.6 percent year-over-year increase — all while owing Mercy Health more than $100M in late and unpaid claims.”

Mercy said it has been experiencing inflationary, labor and supply cost changes.

Anthem, however, said Mercy’s desired rate is more than double the rate of hospital inflation and accused Mercy of trying to leverage higher rates from non-medicaid members by terminating medicaid members.

“Mercy Health is not seeking increased payment for our Medicaid members, they are terminating their contract to serve this vulnerable population in an attempt to force higher costs on our employer-based and individual plan members,” Jeff Blunt, Anthem spokesman said via email Thursday.

Anthem said it is offering continuity of care for those on Medicaid with serious and complex conditions, while hoping for a last-minute agreement.

“We are committed to reaching resolution as quickly as possible,” it said. “Meanwhile, we continue to assist members with transitioning care to alternate care providers.”

Mercy Health is encouraging patients to call Anthem using the number on the back of their insurance cards to for care options beginning Saturday.

Patients with qualifying conditions can be eligible for continuity of care. Anthem BCBS of Ohio must provide services to members regardless of whether services were prior authorized / pre-certified or the treating provider is in or out-of network with Anthem BCBS of Ohio if they have a qualifying condition. Information on continuity of care can be found on Mercy Health’s website, Mercy Health stated.

Additionally, patients also should call the Ohio Office of Medicaid, 800-324-8680, to understand options for maintaining access to Mercy Health facilities and providers.

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