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Salinas Valley Health, Anthem Blue Cross reach multi-year agreement on new contract

SALINAS, Calif. (KION) -- Salinas Valley Health and Anthem Blue Cross reached an agreement on a new contract that applies to Anthem members enrolled in individual and employer-sponsored health plans.

The contract is also retroactive to August 1, 2023.

The announcement was made by Salinas Valley Health on Monday afternoon.

“This new agreement demonstrates the strong commitment by both organizations to deliver access to high-quality, affordable care for the commercial health plan members we mutually serve in Monterey County – a win-win for employers and consumers,” said Beth Andersen, President of Anthem Blue Cross. 

The news from SVH comes after Hazel Hawkins Memorial Hospital in San Benito County extended its contract with Anthem Blue Cross a few weeks ago.

“We are pleased with this new contract,” says Pete Delgado, Salinas Valley Health President/CEO. “Our leadership team as well as our counterparts at Anthem worked hard to reach an agreement that serves our patients and community. We believe we have negotiated a contract that allows us to continue to deliver quality healthcare for the residents of Monterey County, while also improving reimbursements for that care.”

KION is reaching out to SVH to learn how long the contract lasts for.

SVH to cover in-network costs until end of year after no agreement with Anthem Blue Cross

After more than two months of failed negotiations between Anthem Blue Cross and Salinas Valley Health 11,000 patients have been left with no choice but to look for another healthcare provider.

This is causing people like Jess Barreras to be worried, that health services for him and his family might not be covered if a deal isn't made.

"I have to look for a primary care physician, a sleep therapist, a diabetes care physician, a podiatrist, a physical therapist, orthopedics and a hospital," said Barreras.

The past two months have been stressful, to say the least for Jess. He says he's a heart transplant candidate and sees 6 doctors at SVH.

Living in Soledad, Jess is worried about distance in case of an emergency.

"That's going to be a bit worrisome because I either have to go out and Natividad Chomp and Chomp as an hour away from my home," said Jess.

"As federal elected officials, we do not have oversight of state-regulated health insurance plans. However, as federal officials, we have steadfastly worked to protect the tenants of the Affordable Care Act to deliver more accessible and affordable care for everyone we represent. As such, we hope you continue contract discussions with SVH,"said Jimmy Panetta and Zoe Lofgren, members of congress in a letter to Anthem.

We're also hearing from Salinas Valley Health, they say: "Salinas Valley Health had hoped five months of covering out-of-network costs would be enough time to reach an agreement. Anthem, however, is taking an unreasonable position."- Augustine Lopez, Salinas Valley Health CFO.

Anthem Blue Cross will also cut off services to 14 other counties in California including San Benito.
Salinas Valley Health is honoring in-network prices until December 31st.

Below is information from Salinas Valley Health on patients who qualify for Continuity of Care services.

Certain patients, including those who are hospitalized, pregnant, or undergoing an active course of treatment before the contract expiration date may qualify for Continuity of Care services through Anthem Blue Cross.

Q: What if I’m in the hospital when the contract ends on August 1, 2023?

A: Patients receiving services at our hospital or clinics will be covered at in-network rates.

Q: What are some examples of services that may be eligible for coverage under the Anthem Blue Cross Continuity of Care program after August 1, 2023?

A: Examples of conditions that may qualify for Continuity of Care services include those listed below.

Type of Problem or ConditionHow long do you get continuity of care
Acute condition (for example, pneumonia)As long as the condition lasts
Serious chronic condition (for example, severe diabetes or heart disease)No more than 12 months. Usually, until you complete a period of treatment and your doctor can safely transfer your care to another doctor
PregnancyDuring Pregnancy and immediately after the delivery (the post-partum period)
Terminal illnessAs long as the person lives
Care of a child under 3 yearsFor up to 12 months
An already scheduled surgery or other procedure (for example, knee surgery or colonoscopy)The surgery or procedure must be scheduled to happen within 180 days of your doctor or hospital leaving your health plan
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Dania Romero

Dania Romero is an reporter at KION News Channel 46.

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