Anthem includes “most-favored nation” clauses in some contracts, which prohibits providers, including hospitals and physicians, from offering lower rates to another payor, according to the report. These arrangements are illegal in 12 states, but are legal in Connecticut. Governor Richard Blumenthal’s office is currently investigating these arrangements, according to the report.
Hospitals had been afraid to participate in Connecticut’s Charter Oak Health Plan, a state-subsidized plan that uses commercial contractors, because of the potential impact it may have on their rates with Anthem, according to the report. As a result, some counties had no hospitals that were considered in-network for Charter Oak.
In Dec. 2009, Gov. Blumenthal asked Anthem to assure hospitals that the insurer would not expect the same discounts as were given to Charter Oak. On Jan. 28, 2010, Anthem agreed, but physicians were not included in the waiver.
Officials from the Connecticut State Medical Society have opposed Anthem’s used of “most-favored” clauses in their contracts and are urging the insurer to release physicians from the same stipulations, according to the report.
Read the AMNews report on Anthem of Connecticut.
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