Anthem, Valley Health Resolve Lawsuit Over Past-Due Payments

Regional health system Valley Health has reached a settlement agreement with Anthem Blue Cross and Blue Shield, resolving a dispute over past-due payments for healthcare claims, according to a press release emailed to HealthPayerIntelligence.

Valley Health filed the lawsuit against Anthem, now known as Elevance Health, in the Circuit Court of the City of Winchester in October 2022. The lawsuit included two counts: Breach of Contract and Violation of Virginia Ethics and Fairness in Carrier Business Practices Act.

Specifically, Valley Health sought to recoup $11.4 million in past-due payments that it claimed Anthem contractually owed to the health system, some of which were years past due, according to Mark Nantz, president and chief executive officer of Valley Health.

The health system stated that it had worked quietly with Anthem for two years to try and resolve the reimbursement issues. But the health system eventually chose to file a lawsuit to hold Anthem “accountable for the harmful effects of their payment delays that ultimately impact [its] ability to sustain quality community healthcare services.”

According to Valley Health, Anthem made $6.1 billion in profit in 2021, while the health system faced ongoing financial challenges due to the COVID-19 pandemic and rising inflation.

However, Valley Health has abandoned its lawsuit after the two organizations spent several months working in good faith to reach a settlement.

“We were pleased to be able to reach an agreement with Anthem without continuing this dispute in the courts,” Nantz said in the press release. “We hope our dialogue moving forward will be productive so that we can continue to serve Anthem beneficiaries into the future. The resolution of this dispute enables Valley Health to drop the lawsuit and to formally enter into negotiations to extend our current contract with Anthem.”

The organizations’ current contract ends on December 31, 2023. Previously, Valley Health planned to terminate the contract with Anthem and expected the lawsuit to continue into 2024.

“We’re glad we could bring this matter to resolution. We can now focus our attention on continuing the long partnership we have had with Valley Health, ensuring access to care as we work to improve the lives of the people and communities we serve here in Virginia,” Kurt C. Small, president of Anthem Blue Cross and Blue Shield East Region, said.