Northern Light Health and Anthem Blue Cross Blue Shield agreed Wednesday to resume contract talks and keep the insurer’s patients from being out-of-network for some health care services.
The two sides said they will resume negotiations for a contract, which will determine how much Anthem pays for Northern Light’s services.
Under the previous contract terms, Northern Light would have been out-of-network for physicians, specialists and walk-in clinics starting on Wednesday, and for hospital services starting on Dec. 31. After Wednesday’s deal, the contract for non-hospital services has been extended and now ends Oct. 31.
The agreement allows “both parties to continue working toward a long-term agreement that prioritizes affordability, patient access, and quality of care,” according to a joint statement from the insurance carrier and hospital network.
The two sides have been negotiating for months and in a formal mediation process since August, but a negotiating session on Tuesday ended without any resolution, resulting in Northern Light briefly being out-of-network for some services.
Patients were left scrambling for a few hours until the joint announcement Wednesday. The agreement is retroactive, so patients will not have to pay out-of-network costs for using Northern Light, even if they had a doctor’s appointment on Wednesday.
Gov. Janet Mills said in a statement Wednesday that she got personally involved to help resolve the impasse.
“In our meetings (Friday), I pushed both parties to agree to a 30-day extension to continue contract negotiations, an effort that was successful,” Mills said in the statement. “While this extension is a better alternative than a lapse, I called on them — as I do again now — to resolve this stalemate and to reach a fair and equitable agreement once and for all.”
Mills said a contract termination would be “unacceptable and would have devastating impacts” by jeopardizing access to health care.
Mitchell Stein, a Maine-based independent health policy analyst, said he’s pleased “saner heads prevailed.”
“It was in both of their interests not to have this war, because of the potential harm to patients and both organizations,” Stein said.
About 30,000 Anthem enrollees are Northern Light patients, including state employees and some nurses and firefighters.
Michael Crouse, secretary of the Professional Firefighters of Maine union, said he received many calls and emails Wednesday morning from union members worried about the status of their health insurance.
“This was really hitting home,” Crouse said. He said for some firefighters in northern Maine, almost all of the health care services nearby were Northern Light. That would have meant traveling long distances for health care appointments to avoid out-of-network costs.
Out-of-network patients can still be seen by health care providers, but the out-of-pocket charges for the patients will typically be much higher.
Northern Light operates Eastern Maine Medical Center in Bangor, Mercy Hospital in Portland, and a network of primary care and specialist services in much of northern and central Maine.
Stein said he believes the uncertainty caused by Congress not deciding on whether to extend enhanced Affordable Care Act subsidies is making contract negotiations between insurers and hospital networks more complicated. Both insurers and hospitals are facing financial pressures because, if the ACA subsidies expire at the end of 2025 and Congress does not act, their bottom lines would be harmed, he said.
The contract dispute heated up last week, with Anthem officials accusing Northern Light of walking away from mediation.
Northern Light officials said they were willing to negotiate. The difficult contract talks resembled a standoff between MaineHealth and Anthem in 2022 that was settled without any disruption in services.