August 10, 2021
After months of negotiations, Dignity Health California and Anthem Blue Cross failed to reach a new contract agreement. As a result, the contract between Dignity Health and Anthem has terminated. More details about the impact and timeline of the termination can be found on the Dignity Health website.
According to health plan filings with the California Department of Managed Health Care (DMHC) , the termination of the Dignity Health Medical Foundation physicians HMO commercial contract impacts 4,963 enrollees with Dignity Health Medical Foundation Santa Cruz and 4,576 enrollees with Mercy Medical Group in Sacramento. Affected enrollees have been notified by Anthem of the termination date and reassignment to alternative medical groups in each area.
Patients undergoing current courses of treatment may be able to continue to see their out-of-network physicians under California’s continuity of care law. Health plans, at the enrollee’s request, must provide for the completion of covered services as follows:
For a serious chronic condition
For the duration of a pregnancy
For the duration of a terminal illness
For the care of children between birth and 36 months
For the performance of a surgery or other procedure that has been authorized, may qualify to request continuity of care. To request continuity of care, patients should call the health plan number on the back of their ID cards or the form can be located at www.anthem.com/ca/forms and by selecting “Continuity of Care/Transition of Care Request Form.”
For more information on continuity of care requirements, see CMA Health Law Library document #7051, “Contract Termination By Physicians and Continuity of Care Provisions.”
Physicians who have additional questions can contact Dignity Health at (800) 483-1568.
Physicians can also contact their Anthem Blue Cross Contract Support-Provider Experience representative as indicated on the Anthem provider website.