As of Oct. 1, 2025, Northern Light Health will be out of network with Anthem for physicians and some ancillary services, and effective Dec. 31, 2025, will be out of network with Anthem hospital-based services.

WITH BOTH COMPANIES TO UNDERSTAND WHAT’S GOING ON…. SHE JOINS US LIVE IN STUDIO TONIGHT – AND CATE WHAT CAN YOU SHARE? NORTHERN LIGHT HEALTH SAYS ANTHEM INSURANCE IS COVERING TOO LITTLE… .BUT ANTHEM IS SAYING NORTHERN LIGHT IS ASKING FOR TOO MUCH – AND THEY HAVE UNTIL THE END OF NEXT MONTH TO STRIKE A DEAL….. “WE WANT TO MAKE SURE THAT THEIR MEMBERS HAVE ACCESS TO SERVICES AT NORTHERN LIGHT HEALTH. BUT WE ALSO WANT TO MAKE SURE THAT, THAT WE’RE PAID, FAIRLY FOR THE SERVICES THAT WE’RE PROVIDING.” NORTHERN LIGHT HEALTH – WHICH OPERATES SEVERAL HOSPITALS THROUGHOUT THE STATE – IS HOPING TO RECEIVE MORE REIMBURSEMENT FROM INSURANCE PROVIDER ANTHEM BLUE CROSS BLUE SHIELD. ” THERE’S A BIG GAP BETWEEN THE 1.5% INCREASE WE’VE BEEN GETTING AND THE INCREASE IN THE PREMIUMS THAT THEY’VE BEEN MAKING” THEIR CHIEF FINANCIAL OFFICER SAYS INFLATION HAS DRAMATICALLY INCREASED THE COST OF CARE AND CLAIMS ANTHEM IS FAILING TO ADEQUATELY REIMBURSE HEALTHCARE PROVIDERS….YET ANTHEM LEADERSHIP DISAGREES “WE’VE PROPOSED PRICE INCREASES THAT ARE ABOVE THE RATE OF INFLATION AND WOULD ENSURE THAT NORTHERN LIGHT HEALTH CONTINUES RECEIVING PAYMENTS THAT ARE COMPARABLE TO OTHER MAINE SYSTEMS.” ANTHEM CLAIMS IF THEY INCREASE REIMBURSEMENTS AS MUCH AS NORTHERN LIGHT WANTS – PATIENTS WOULD HAVE TO PAY MUCH MORE FOR HEALTH INSURANCE… “THESE INCREASES ARE NOT AFFECTING ANTHEM. THEY ARE AFFECTING OUR CUSTOMERS AND OUR MEMBERS WHO ARE THE PATIENTS OF NORTHERN HEALTH LIGHT.” AND IF THE TWO SIDES FAIL TO REACH A DEAL BY SEPTEMBER 30TH – ANTHEM INSURED PATIENTS MAY NEED TO SEEK CARE OUTSIDE OF THE NORTHERN LIGHT HEALTH SYSTEM. “WE WOULD BE OUT OF NETWORK FOR ANTHEM MEMBERS AND, AND THE MEMBERS WOULD THEN, YOU KNOW, HAVE TO TAKE RESPONSIBILITY FOR THE, THE, THE BILLING FOR BASICALLY PAYING THEIR LIGHT HEALTH.” THIS ISN’T THE FIRST TIME WE’VE SEEN CONTRACT DISPUTES BETWEEN HEALTH SYSTEMS AND INSURERS….AND IN RECENT YEARS THE PARTIES DID ULTIMATELY REACH AN AGREEMENT. BOTH EXECUTIVES I SPOKE WITH TODAY SAY – THAT IS WHA

Advertisement Northern Light Health says it is ending its contract with insurance provider Anthem As of Oct. 1, 2025, Northern Light Health will be out of network with Anthem for physicians and some ancillary services, and effective Dec. 31, 2025, will be out of network with Anthem hospital-based services. Editorial Standards ⓘ

Northern Light Health announced Friday it is ending contract negotiations with health insurance provider Anthem Blue Cross Blue Shield. That means that, as of Oct. 1, 2025, Northern Light Health will be out of network with Anthem for physicians and some ancillary services, and effective Dec. 31, 2025, will be out of network with Anthem hospital-based services. Starting Jan. 1, 2026, Northern Light Health system, including hospitals, clinics, and physicians, will be out of network with all Anthem Medicare Advantage Plans. Emergency care is always covered, at the in-network cost-sharing level, no matter the contract status with Anthem.Video in the media player above is from a report earlier in August before Northern Light announced it was ending negotiations.Northern Light Health is one of the largest healthcare systems in Maine and said in June that talks for a new contract with Anthem had stalled.Northern Light Health says it sent a letter Friday to Anthem leadership detailing a list of concerns and issues that they have experienced since negotiations began several months ago. “It is unfortunate that Anthem has decided not to focus its efforts on engaging in productive discussions to negotiate an agreeable deal that would benefit our patients by ensuring continued payment for the services Northern Light Health provides,” said James Rohrbaugh, CPA, executive vice president and chief financial officer, Northern Light Health. “To continue delivering this high level of service, we rely on fair and sustainable partnerships with insurers like Anthem. We need Anthem to come alongside us through a contract that reflects our region’s unique healthcare needs and economic environment.” Northern Light did say Friday that if Anthem comes back with what Northern Light considers a reasonable offer, they will consider it.”The time has arrived, though, where Northern Light Health cannot stand passively awaiting a constructive proposal when there is no indication of a desire to that end on the part of Anthem,” Northern Light said in a release.If patients have questions, they can visit northernlighthealth.org/anthem for more information and details on alternative insurance plans that Northern Light Health accepts.Anthem provided a response to Maine’s Total Coverage saying they were disappointed by the word that Northern Light is ending negotiations weeks before the end of the contract. “We remain committed to working with Northern Light to reach a new contract in the weeks ahead. It’s the right thing to do for our members who are Northern Light patients. So, we intend to keep the lines of communication open,” Anthem said in a statement. “As we have shared with you previously, we also remain committed to doing everything we can to keep healthcare as affordable as possible across Maine. Agreeing to the approximately 30 percent price increase (over three years) that Northern Light has demanded is not in the best interest of our members. They would end up having to pay more than $200 million more in health care costs over the life of the proposed three-year contract. Also as we have shared, it’s important to us to compensate Northern Light fairly – based, in part, on important healthcare quality measures. Northern Light has asked that we drop all quality-related compensation from our next contract, which concerns us.”