Bon Secours, Anthem reach deal to end dispute that left Virginia Medicare patients out of health system’s network

RICHMOND, Va. (WRIC) – Bon Secours and Virginia’s largest health insurer have reached a new multi-year deal, ending a contract dispute that left thousands of Medicare recipients out of the health system’s network for months.

The agreement between Bon Secours Mercy Health, a health system with hospitals in the Richmond and Hampton Roads areas, and Anthem Blue Cross Blue Shield, the state’s largest health insurer, was announced Friday after months of discussions over a new contract.

The two sides could not come to an agreement at the start of August, leaving 11,000 Anthem Medicare Advantage patients out of the health system’s network and with higher out-of-pocket costs.

The new deal, which goes until 2028, means those Medicare recipients are back in Bon Secours’ network. The agreement also keeps 39,000 Virginians on Medicaid plans managed by Anthem Blue Cross and Blue Shield from losing coverage in Bon Secours’ network starting Oct. 1.

“I’m proud that both organizations continued to focus on our shared priority: the communities we serve,” said Anthem Virginia President Monica Schmude.

Specific details of the new deal were not released, with both sides citing “confidentiality provisions in the contract.”

But the companies shared Anthem will cover any claims that Medicare Advantage patients may have had when their in-network coverage at Bon Secours stopped Aug. 1 and that Bon Secours would drop its $93 million lawsuit claiming late and unpaid claims by the insurer.

The deal extends coverage for Anthem employer-based and Affordable Care Act plans, the companies said, until 2028.

During the contract dispute, Bon Secours claimed its reimbursement rates from Anthem did not keep pace with the rising costs of labor, supplies and medications, arguing it undermined its “ability to provide care.”

“We understand that being out of network can be very difficult, and we are pleased that patients with Anthem insurance can now see our physicians and use our hospitals at an in-network cost,” Don Kline, Bon Secours Mercy Health’s chief operating officer, said Friday.