ACEP is acting now in hopes of preventing disruption before the policy takes effect or sets a dangerous precedent for other payers.

A Larger Pattern of Insurer Bad Behavior

Emergency physicians know all too well that the effects of policies that narrow insurance networks land squarely on their shoulders, as they are legally required to treat all patients regardless of insurance status. The fight against Anthem’s new policy is one battle in ACEP’s broader campaign to hold insurers accountable when their proposals threaten the stability of emergency care.

As insurer maneuvering has continued to ramp up, ACEP has fought back at every turn. ACEP has continually applied pressure to compel insurance companies to roll back dangerous and frequently unlawful policies, including payment denials, downcoding, reimbursement delays, and other tactics putting emergency departments at financial risk.

Recently, ACEP strongly supported the No Surprises Enforcement Act, which will hold insurance companies accountable for continued and willful violations of the federal law.

The No Surprises Enforcement Act “takes critical steps to level the playing field and stop insurer bad practices,” said Alison Haddock, MD, FACEP, immediate past president of ACEP. “Insurers consistently refuse to play by the rules, doing all they can to delay payments, or in some cases are outright failing to meet their obligations under current law. This bill will hold bad actors accountable and stop their dangerous, irresponsible abuse of the system.”

ACEP remains committed to working with Congress and state and federal regulators to make sure insurance companies conduct business in good faith and in line with current law.

What Comes Next

It is not clear yet whether Anthem plans to revise or withdraw the penalty. ACEP continues to monitor the situation, and ACEP has met directly with Anthem leadership to discuss its concerns.

What is clear is that ACEP will continue to lead efforts to ensure payer policies support the delivery of timely, reliable emergency care. ACEP’s engagement on this issue reflects its commitment to defending the stability of emergency medicine and to making sure emergency physicians have a strong, unified voice whenever insurer decisions threaten the care on which their patients rely.