Norton Healthcare Contract Status for IU-sponsored Medical Plans

This web page has been created to provide employees with information about Norton Healthcare’s network status as it becomes available. Updates will be posted periodically.

June 30, 2009 1:36 P.M.

Anthem has announced that it is going to take parents and children who have services at Kosair Children's Hospital out of the middle of this dispute by paying the member at the rate Norton has requested in its previous proposal for services performed at Kosair Children’s Hospital. Kosair went public last night that they would bill members to their requested rate, not at billed charge.

June 29, 2009
 
In an effort to keep employers updated on the status of their contract with Norton Healthcare, Anthem has provided a web site for this purpose available at http://group.anthem.com/norton. As information becomes available, Anthem will post updates.

June 26, 2009

Anthem reports that a third party mediator has been engaged to assist Anthem and Norton in resolving their contract issues. This mediation was unsuccessful. Although discussions between both parties continue, Norton’s business decision to terminate its contact with Anthem as of June 30, 2009, has not changed. This means that unless an agreement is reached, services received from a Norton Healthcare provider on or after July 1, 2009, will be out-of-network for those enrolled in the IU PPO $900 Deductible, Blue Preferred POS, and IU HDHP POS & Medical Savings plans. Anthem has made available a letter to its members (PDF) and a list of alternate hospitals (PDF). Those in a current course of treatment or who are in their second or third trimester may be eligible for transition of care benefits for a period of time by contacting the Member Service phone number on the back of their Anthem ID card. Assistance in selecting a new health care provider can also be obtained through Member Services or by going to Anthem's Provider Finder.

The University continues to monitor this situation and will notify employees of any change.

June 12, 2009

University Human Resource Services continues to monitor the contract status between Anthem and Norton Healthcare. Although Anthem has a contract with Norton Healthcare that runs through September 30, 2010, Norton has notified Anthem of their intention to terminate the contract early, effective July 1, 2009. This puts IU employees in a difficult position of uncertainty about in-network benefits after June 30, 2009.

If an agreement is not reached before July 1, 2009, services provided on or after that date by Norton Healthcare facilities or affiliated physician practices will be paid at the out-of-network benefit level.

Norton Healthcare includes the following hospitals as well as other affiliated diagnostic/imaging facilities and physician practices:

• Norton Audubon Hospital
• Norton Hospital
• Norton Suburban Hospital
• Kosair Children's Hospital

In the event that Norton Healthcare does not rejoin Anthem Preferred Provider networks, there could be increased medical claims costs for both members and plan reimbursements when Norton Healthcare and its affiliates are used. These cost increases would be the result of:

• higher out-of-network deductibles and copays for members,
• member responsibility for excess provider charges above ‘Usual & Reasonable’ amounts (amounts that in-network providers write off without billing the member); and
• medical plan payments for amounts above ‘Usual & Reasonable.’

Members can call Anthem’s Customer Service at 800-345-2460, or go to Anthem's Provider Finder to locate participating network hospitals, free-standing surgery centers, and imaging/diagnostic services locations. If you are unsure what type of provider can duplicate the services that you currently receive at a Norton Healthcare affiliate, ask your physician for names of providers for Anthem to check for network status. Consulting your physician is always best, but if you cannot do so, you may also ask Anthem to assign a nurse case manager by calling 800-737-1857, to help you identify the types of services and network providers that can provide the services you need.