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Anthem insurance being dropped by Coastal Women's Healthcare for in-network coverage in late August

Staff wrote the current reimbursement rates for services it provides to Anthem's members are "much too low."

SCARBOROUGH, Maine — Another Maine healthcare provider plans to drop Anthem insurance due to the inability to negotiate reimbursement rates that the two companies can agree on.

Maine's Coastal Women's Healthcare (CWH) is the largest independent OB/GYN practice in the state with roughly 22,000 total patients, according to the practice's president, Dr. Barbara Slager.

Tuesday, CWH sent a letter to roughly 8,000 current and former patients over the last three years who use Anthem for their insurance, telling them about the practice's plan to stop accepting Anthem starting Aug. 23, 2022.

Staff wrote the current rates of reimbursement for services it provides to Anthem's members are "much too low to allow us to continue to provide the level of quality care that our patients have come to expect from us."

In the letter, staff said pregnant patients, or patients currently in active care plans, will continue to receive care until their care plans are completed.

"That means if you are pregnant, regardless of your delivery date, we will continue to see you as a patient through your delivery and post-delivery care," the letter says. "We recommend you reach out to Anthem directly at the number on the back of your insurance card to discuss any impact on your cost-sharing obligations. We sincerely regret any impact this difficult decision has on our patients, but we are absolutely committed to continuing the course of treatment for our current patients."

President Dr. Barbara Slager said roughly 38 percent of CWH patients have Anthem. She said Anthem used that large percentage as leverage to offer low reimbursement rates, knowing that if CWH did not renew the contract, it could possibly go out of business.

"They're relying on us being scared of that," Dr. Slager said. "It's that or go out of business."

When asked if dropping Anthem will accomplish reaching negotiations, Dr. Slager said, "at this point we feel like we have no other choice but to take a stand on this. We will continue to attract patients from different payers." 

In response, Anthem's spokesperson, Stephanie DuBois, wrote in a statement:

“Coastal Women’s Healthcare provides quality, personalized care and we consider them to be an important part of our care provider network. We believe they should be compensated fairly for the care they give our members and that has been our goal in negotiations with them. To that end, we have offered them generous increases over the next several years, which they rejected.

"We’ve also offered a one-year extension with a substantial increase in rates to provide time to finalize a longer-term deal, which they also turned down. Instead, Coastal Women’s is insisting on a 70 percent increase in reimbursement rates, which we cannot agree to because it will greatly impact affordability for our members. 

"It’s extremely disappointing they have chosen to walk away from negotiations by announcing an intention to leave our network, understandably causing concern among consumers. We urge them to re-engage in good faith negotiation efforts with us so our members can continue to receive the care they rely on from Coastal Women’s Healthcare.”

A spokesperson for Coastal Women's Healthcare said the practice did not ask for a 70 percent increase, and never received an official offer for a one-year deal to bridge the potential gap in coverage.

Fore River Urology, another independent practice in Maine, sent a similar letter to roughly 10,000 of its patients notifying them it would drop Anthem for in-network coverage starting Aug. 1, 2022, also due to failed negotiations.

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