Northern Light Health and Anthem appear to have again reached an impasse as their existing contract rapidly approaches its expiration date.
Despite talk about a month ago of both parties being open to mediation, it appears that negotiations between the insurance provider and health care system have once again fallen through.
Unless an agreement can be reached, 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 would become out-of-network with all Anthem Medicare Advantage Plans as of January 1, 2026.
[RELATED: Mediation Now a Possibility in Stalled Contract Negotiations Between Northern Light and Anthem]
In statements issued Wednesday, both Anthem and Northern Light indicated that the other had been the one to end negotiations.
“For the second time in two months, Northern Light Health has walked away from negotiations with Anthem, including abandoning the mediation process we both agreed to,” the insurance provider’s statement said.
Northern Light published a statement on their Facebook page shortly thereafter to “correct the record.”
“Northern Light Health is disappointed to hear that Anthem publicly disseminated egregious misrepresentations of our mediation discussions,” the health care system said. “We have made no indication that we are walking away from negotiations and their statements are not constructive to the mediation process.”
As the statements go on, both parties appear to paint a very different picture of how negotiations have unfolded.
While Northern Light has said that Anthem refuses to “requests for contract language that protects Northern Light Health and the patients we serve,” the insurance provider has accused the health care system of refusing to make adequate compromises.
“While we have more than doubled our initial offer, now up to a 5% increase for Commercial business, Northern Light has reduced its demand only slightly, insisting that Mainers and employers increase payments to Northern Light by nearly $200 million over the next three years,” wrote Anthem.
Both Northern Light and Anthem indicated in their statements Wednesday an openness to continue negotiations if the other side is willing to budge on these concerns.
Click Here to Read Anthem’s and Northern Light’s Full Statements
Patients insured by Anthem and receiving care at Northern Light facilities will not necessarily be forced to go elsewhere if their contracts expire, but any services rendered would be treated as out-of-network.
As a result of this, any Anthem-insured patients who choose to continue receiving care at Northern Light facilities will likely face higher out-of-pocket costs.
Medicare Advantage patients would 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 Medicare Supplement Plans — also known as Medigap Plans — through Anthem will not be impacted, as these plans do not have network requirements in Maine.
