LACONIA, NH - LRGHealthcare announced today that its professional provider network contract with Anthem expired April 15, 2008. The expired contract affects all services provided by LRGHealthcare’s affiliated physicians and providers. The hospital contracts for both Lakes Region General Hospital and Franklin Regional Hospital have been signed, and are in effect. Both facilities remain in the Anthem network.

“LRGHealthcare is committed to maintaining our community’s local access to primary and specialty physicians and providers,” says LRGHealthcare President & CEO Tom Clairmont. “In order to accomplish that, we must obtain payment that is sufficient to retain physicians and to cover the cost of providing care.

“We have been negotiating with Anthem to seek sufficient payment levels for LRGHealthcare physicians and providers for nearly a year. Through this negotiation, we need to close the funding gap created by the difference between Anthem’s existing payment levels to physicians and the practices’ cost for providing service. While we are still attempting to negotiate what we feel is a fair and needed contract for our community providers, we have not yet been able to come to agreement.”

Over the next few days, local Anthem subscribers can expect to receive a letter from Anthem notifying them that many local physicians will soon be non-contracted, and will be out of the Anthem network.

The existing contract expired on April 15, 2008. However, due to Department of Insurance regulations, our contracts will continue for at least the next 60 days, and likely beyond that without interruption—It is unlikely that there will be any change in contract status before mid-August. After that time, if Anthem does not agree to provide our community with the payment we need to maintain the access to physician services our residents need and deserve, many of our local providers will no longer be contracted with Anthem. For Anthem subscribers, this means that many local providers will be considered out-of-network for benefit administration purposes. Medicare supplemental plans, sometimes referred to as Medicomp, Medigap, Plans A-J, or Medicare Advantage are not impacted by this impasse.

“It is important to remember three things,” says Clairmont. “First and foremost, LRGHealthcare provides care to all in our community, regardless of ability to pay. Second, there are many options to assist you in this situation, including numerous other insurers with whom our local providers are contracted; the HealthLink Program for healthcare financial counseling and assistance; and the Patient Advantage Program, which provides prompt pay discounts of up to 20% for all of our patients. And third, that contract negotiations are ongoing, and we truly hope to come to terms with Anthem before the end of the contract extension.”

If this issue is not resolved in the coming weeks, we will hold Community Forums to give local Anthem subscribers the opportunity to learn more, and to ask any questions they may have. We will also provide information regarding other insurers with whom the local provider network is contracted.

“We apologize for any inconvenience this may cause, but we assure you that we are acting in the best interest of our community,” says Clairmont. “We cannot, in good conscience, accept a contract that will not support the current and future healthcare needs of our community.”

* Anthem Contract Expiration Frequently Asked Questions
* Practices and Providers Impacted by the Anthem Contract Impasse

FOR MORE INFORMATION CONTACT:
Office of Public Relations & Marketing
80 Highland Street
Laconia, NH 03246
Phone (603) 737-1041
Fax (603) 737-1027