Northern Light, one of Maine’s largest health care systems, said that it has ended talks with Anthem Blue Cross Blue Shield after months of stalled negotiations.
All physicians and some ancillary services will become out-of-network with Anthem on October 1, followed by all hospital-based services on December 31.
The entire Northern Light Health system will become out-of-network with all Anthem Medicare Advantage Plans as of January 1, 2026.
[RELATED: Talks Between Northern Light and Anthem Stall as Deadline for New Contract Approaches]
In a written statement shared Friday, Northern Light suggested that Anthem’s “decision to withhold interim payments for services provided and a cumbersome prior authorization process” made it difficult to care for patients, they said.
Despite this, Northern Light has said that it would consider reopening negotiations with the insurance provider “in the event that Anthem comes back with a reasonable offer.”
“We will no longer accept terms that fail to recognize the unique needs of our region and the economic realities we face,” Northern Light said. “Our patients, physicians, caregivers, and communities deserve better.”
Click Here to Read Norther Light’s Full Statement
According to the Portland Press Herald, Anthem responded to Northern Light in a written statement shared Friday, indicating their intention to continue working with the health care system as much as possible ahead of their contract’s expiration date.
“We at Anthem are disappointed to learn that Northern Light Health is indicating they will discontinue negotiations – with several weeks and months to go before their contracts with Anthem are supposed to terminate,” the statement reads in part.
“We remain committed to working with Northern Light to reach a new contract in the weeks ahead,” Anthem continued. “It’s the right thing to do for our members who are Northern Light patients. So, we intend to keep the lines of communication open.”
While Northern Light has accused Anthem of undercutting them financially, the insurance provider intimated that the health care system’s demands would cause millions of dollars in cost increases for other Anthem members over the life of Northern Light’s proposed three-year agreement.
According to Northern Light, Anthem has only increased their reimbursement rates by less than an average of 1.5 percent annually, failing to keep pace with the average 7.5 percent inflation rate in the industry.
Anthem, on the other hand, has argued that Northern Light wants to implement a 30 percent price increase, creating an estimated $218 million in new healthcare costs, most of which they say will fall on the shoulders of patients and employers in the form of co-payments and premiums.
Northern Light has painted Anthem as unwilling to keep up with rising costs, while Anthem has framed Northern Light as wanting to drastically increase costs for patients.
Although a similar dispute played out between Anthem and MaineHealth in 2022, the two were able to reach a deal before the contract expired, averting interruptions for patients.
Patients insured by Anthem and receiving care at Northern Light facilities will not necessarily be forced to go elsewhere after their contracts expire, but any services rendered will be treated as out-of-network.
As a result of this, any Anthem-insured patients that choose to continue receiving care at Northern Light facilities will likely face higher out-of-pocket costs.
Medicare Advantage patients will have the ability to choose a new plan or return to original Medicare during the open enrollment period between October 15 and December 7.
Those who have Mediare Supplement Plans — also known as Medigap Plans — through Anthem will not be impacted by Northern Lights ending their contract, as these plans do not have network requirements in Maine.
