Hazel Hawkins Says Negotiations For Appropriate Payout Rate With Anthem Are Not Effective
“…our organization must champion the financial stability of our district,” said HHMH CEO Steven Hannah.
Hazel Hawkins Memorial Hospital issued the following press release on August 4, 2022:
Anthem Blue Cross PPO (Anthem), the second largest health insurer in the United States, is refusing to properly pay Hazel Hawkins Memorial Hospital (HHMH) for health care services. Anthem, a for-profit company, insures more Preferred Provider Organization (PPO) members in California than any other insurance company.* Anthem has until August 10, 2022 to match payment with market rate, otherwise HHMH sera -network” for Anthem PPO members. Emergency medical care is not affected by out-of-network status.
“We have begun to negotiate an appropriate adjustment to market rates in 2020,” said Mark Robinson, Chief Financial Officer. According to a 2021 Kaiser Family Foundation report, average premiums for family insurance coverage have increased faster than inflation over the past 5 years. “HHMH, the only hospital within 25 miles, is expected to provide care to Anthem PPO members at below market rates,” Robinson commented.
Negotiations have been going on for almost three years. In January 2022, HHMH officials provided Anthem with a contract termination notice, hoping that an appropriate rate would be offered.
Unfortunately, a notice of termination is the only tool we have to get Anthem’s attention,” said Steven M. Hannah, President and CEO. “Access to quality health care is a right for the communities we serve, but our organization must defend the financial stability of our district. Anthem, like all other commercial payers, must provide market-competitive reimbursement for healthcare services rendered by Hazel Hawkins Memorial Hospital,” Hannah added.
Ideally, Anthem will provide an appropriate rate increase and this will be rectified by August 10, 2022. If Anthem does not reach a financially fair agreement with HHMH by August 10, 2022, HHMH will no longer be a contracted vendor with Anthem. Blue Cross. PPO. This means that the care Anthem PPO members receive from HHMH will be off the grid on August 11, 2022. Hazel Hawkins Memorial Hospital has established a dedicated team to help Anthem PPO members navigate access care and continuity of care. They can be reached by phone,
HHMH officials are prepared to seriously negotiate or take any other action necessary to receive proper reimbursement for the care we provide and to be back in the network for Anthem Blue Cross PPO members.
Anthem Blue Cross PPO members concerned about the impact of out-of-network care can file a complaint with the Department of Managed Health Care, (888) 466-2219 or www.dmhc.ca.gov, or contact Anthem Blue Cross Customer Service , (844) 971-0117.
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Hazel Hawkins Memorial Hospital
About Hazel Hawkins Memorial Hospital
Hazel Hawkins Memorial Hospital, established in 1907, is licensed as an acute care general hospital and currently operates with critical access designation. As a public agency, our health system provides prompt and efficient care with compassion and a commitment to excellent service. Hazel Hawkins Memorial Hospital (HHMH) serves the health care needs of San Benito County through a coordinated continuum of outpatient primary and specialty medical care as well as diagnostic services in multiple locations. Learn more about Hazel Hawkins Memorial Hospital and our healthcare system by visiting www.hazelhawkins.com