Missouri legislators schedule hearing over MU Health Care, Anthem contract dispute
Haley Swaino
COLUMBIA, Mo. (KMIZ)
A public hearing has been scheduled for June 30 amid the ongoing contract impasse between University of Missouri Health Care and Anthem Blue Cross Blue Shield.
Anthem customers using Medicare Advantage plans have been out of MU Health Care’s network since February and other customers since April, after the two parties failed to reach an agreement for a new contract.
Senate President Pro Tem Cindy O’Laughlin (R-Shelbina) said after months of receiving messages and emails from people across the state who can no longer visit their doctors at MU Health Care because they are insured through Anthem, she decided to ask Sen. Sandy Crawford (R-Buffalo) to hold a hearing.
“I have heard from enough people that my thought was, ‘It does not seem to be getting done,'” O’Laughlin said. “And if there is progress being made, I’m not aware of it. I knew if we scheduled the public hearing, this would put additional incentive into both parties to try and get to an agreement.”
She announced the hearing on social media Friday.
Crawford chairs the Committee on Insurance and Banking, the Senate Interim Committee on Driving Down the Cost of Healthcare and is a member of the Missouri Health Facilities Review Committee. The June 30 meeting will be held by the Committee on Insurance and Banking.
“The committee would like to hear from both sides of the situation, maybe some of the factors involved in their decision making,” O’Laughlin said. “What is creating a situation where we can’t find a compromise and renew the contract so that we have continued care for people who have been going to the doctor at MU and now cannot?”
The expiration of the parties’ previous contract forced the 2.1 million Missourians insured through Anthem to either pay out-of-network rates at MU Health Care clinics and hospitals or seek care elsewhere.
“My biggest concern is for people who are seeing specialty doctors,” O’Laughin said. “And it’s easy to say, ‘Well, you can go and go somewhere else or you can get another doctor,’ but we all know how hard it is to get into a specialist. And if they don’t have your information, there can be months of waiting. And for some people, that’s a life-threatening situation.”
Macon County resident Sharon Baker Pennington said her husband was forced to switch providers to receive necessary care.
“He could not wait for Anthem and the University of Missouri to come to an agreement,” she said. “He needed his pacemaker monitored. Out of network specialists & existing conditions cannot wait for negotiations.”
Many Missouri residents are already struggling to establish and maintain primary care. According to previous reporting, 111 out of 114 counties in the Show-Me State have been designated as a Health Professional Shortage Area.
“Caught in the middle of this is our people who have health conditions that need to be taken care of,” O’Laughiln said. “And it’s distressing to me that we are offering insurance and then all of a sudden we don’t have it and there is no solution. And the idea that you can just transfer somewhere else, that is not even realistic.”
MU Health Care serves patients in all 114 Missouri counties. It is also the only academic health system in Mid-Missouri, including a Level 1 trauma center and a children’s hospital. MU Health Care is one of only two hospitals in the state that provides health care to patients regardless of their insurance status or ability to pay.
About 100,000 patients are insured through Anthem at MU Health Care, a spokesman previously told ABC 17 News. About 7,000 of those patients use the Anthem Medicare Advantage plan.
Negotiations over other Anthem plans, including Affordable Care Act marketplace plans and HealthLink plans, continue with MU Health Care.
An Anthem spokesperson said in an email Monday that MU Health Care has made future meetings with the insurer conditional.
“Despite our repeated efforts to resume good-faith negotiations, MU Health Care has made future meetings conditional on Anthem first meeting their terms— an approach that prevents meaningful dialogue,” the spokesperson said in an email.
A spokesperson previously told ABC 17 News that MU Health Care demanded a price increase of 39% over three years, which was slightly less than their initial proposal.
Anthem told ABC 17 News on Monday that a recently extended proposal to MU Health Care to continue care for more vulnerable patients through Dec. 31, 202,5 was declined.
“Anthem has offered annual rate increases above the Consumer Price Index (CPI), along with the opportunity to earn more through quality-based incentives,” a spokerson said in an email. “MU Health Care has rejected these offers. We want MU Health Care in our network — but not at a rate Missourians can’t afford.”
MU Health Care wrote in a statement that leadership shares O’Laughlin’s concerns.
“While MU Health Care’s negotiating position and expectations have changed over the last 10 months, Anthem’s has not,” the statement says. “A public hearing presents an opportunity for the Senate Committee and the people of Missouri to hear from Anthem directly on why 1-2% increases are all that they have offered in almost a year.”
A MU Health Care spokesman told ABC 17 News in February that it is seeking new rates that cover the increased costs of providing care due to inflation and other market pressures. Anthem’s processing delays and claim denials have also led to increased administrative burdens, the spokesman said.
O’Laughlin said she hopes that through the hearing, the state can facilitate a conversation and possibly offer help to get the parties to reach an agreement.
“Both of them point to cost escalation, and they both say that they are trying to reach an agreement or have given offers,” O’Laughin said. “But their offers have been turned down, so I would just like for both parties to be in the same room at the same time, which has not happened.”
O’Lauglin said she and Crawford hope a resolution is reached before the June 30 hearing.
“I think that both of them would rather continue these negotiations behind closed doors,” O’Laughlin said. “But the problem with that is when we in the Senate hear about it, we hear from one side and then the other side. And sometimes it’s hard to get to the facts, and it’s a little bit easier when you have them both at the same time.”
O’Laughlin said public review could help bring a resolution sooner.
The hearing is scheduled for 1 p.m. June 30 in the Senate lounge.
Check back for updates.