Judge upholds St. Francis-Anthem pact-WEB ONLY

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St. Francis and Anthem have to stay married for now.

Marion County Superior Court Judge Patrick McCarty ruled yesterday that Anthem Blue Cross and Blue Shield, a health insurer, cannot kick St. Francis Hospital & Health Centers out of its provider network before Anthem’s contract expires.

The contract runs until Sept. 1.

In early March, Anthem notified some of its business clients that its relationship with Mishawaka-based St. Francis could come to an end as early as May 1. Anthem accused St. Francis of billing Anthem for services performed outside a hospital at rates for in-hospital services, a practice that leads to higher reimbursements.

Health insurers like Anthem allow health care providers to join their networks if they agree to discount their charges for health services. Anthem encourages its individual customers to go to “in-network” providers by making those customers’ payments higher for “out-of-network” providers.

St. Francis operates hospitals in Beech Grove, Indianapolis and Mooresville, as well as in eight other cities in Indiana. St. Francis has not disclosed how many of its patients are insured by Anthem and could be affected by the contract dispute.

Anthem, a unit of Indianapolis-based WellPoint Inc., claims more than 40 percent of all patients in Indiana, the company reported last month.

A statement issued today by both Anthem and St. Francis said leaders from both organizations are committed to continuing contracts talks and striking a new long-term agreement.

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