The California Hospital Association on May 4 sued Elevance, the nation’s fifth-largest health insurer, to block implementation of a policy it calls unfair and illegal.
The policy, slated to take effect in California on June 1, imposes penalties on hospitals in the Anthem Blue Cross and Blue Shield network that refer Anthem patients to care providers that are out of network.
Hospitals that continue the practice are subject to an administrative penalty equal to 10 percent of the allowed amount for the hospitals’ claims involving non-network providers.
Hospitals that persist could face the termination of their contracts with Anthem.
Hospital and medical associations have criticized the policy and asked for its repeal. …