Anthem highlighting OON Ohio labs as rate adjustments set to hit Dec. 1

November 26, 2019

After several Ohio pathology groups and labs balked at accepting Anthem’s new rates for their services and instead chose to move out of the payer’s network, the insurer has opted for a new approach to put pressure on these providers.

In a recent bulletin to employers, Anthem notified them that a number of groups and labs will be leaving its network Dec. 1 due to disagreements over the new reduced rates, which in many instances are substantially lower than previously negotiated rates and even fall below Medicare averages.

After originally scheduling the rate changes to take effect on July 1, Anthem instead opted to push the change back to Dec. 1 to give providers additional time to consider whether they wanted to remain in network.

The notice warns employers that their employees could be balanced billed by these pathology groups for balances not covered by Anthem’s new rates. They then go on to list the labs in question.

In short, this is an attempt to put these groups on blast — under the guise of protecting consumers — for choosing not to accept these unprecedented rate cuts.

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