A breakdown in contract negotiations between Scripps Health and Anthem Blue Cross has left patients in San Diego facing uncertainty about their healthcare coverage. Lisa Schmidt, a Scripps patient insured by Anthem, expresses her anxieties about the situation.
SAN DIEGO (KGTV) – The start of the New Year is supposed to be about starting with a fresh slate.For Lisa Schmidt, her year is starting as stressful as possible. 'Everything is so uncertain,” Schmidt said. 'It's pretty scary, especially (for) someone who is having next week.'Stress because Scripps Health and Anthem Blue Cross were unable to work out a new contract. Lisa's worried her coverage is now out of network. 'I need care after that surgery.
Everything's uncertain and it doesn't sit well with me,” Schmidt said.The deadline for the two companies to get a deal done passed. Scripps said there were issues with insurance red tape and what they describe as barriers to patient care. While Anthem said Scripps demanded increased prices that would have led to major out-of-pocket costs. We first spoke with Lisa, who's a Scripps patient insured by Anthem, last month as the two companies were negotiating. She told ABC 10News she's dealt with a genetic condition for most of her life; causing long-term health issues and they got worse after contracting COVID-19. 'I just called UCSD because my referral went through neurology over there. So they're having to review to see if they'll take me which is scary right then and there. Like, I'm on treatment for severe migraines with a biologic,” Schmidt said ABC 10News received statements from both Scripps and Anthem. Both sides explain that while negotiations failed they remain open to having further discussions. Anthem’s statement said, “Despite our good faith efforts to reach a new agreement, Scripps has chosen to leave Anthem’s local care provider network effective January 1, 2025. Scripps demanded drastically increased prices for patients covered by Anthem—increases that would have led to higher out of pocket costs for our members and would have hit area employers particularly hard. More than 80% of Anthem Blue Cross members are insured by employers that pay their employees’ healthcare costs directl
HEALTHCARE INSURANCE CONTRACTDISPUTE SCRIPPSHEALTH ANTHEMBLUECROSS
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