Valley Health settles suit with Anthem Blue Cross and Blue Shield

Photo byKarolina Grabowska (via Pexels)

WINCHESTER, Va. – A multi-million dollar Valley Health lawsuit filed against Anthem Blue Cross and Blue Shield has been settled.

In October 2022, Winchester-based Valley Health said it was suing Anthem to recoup $11.4 million in past due payments. The suit, initially filed in Winchester Circuit Court, advanced to federal court and increased to $15 million.

In January 2023, Valley Health President and Chief Executive Officer Mark Nantz announced that the two parties remained in a "severe disagreement" and that the court case would likely extend into 2024, past the end-of-year contract deadline.

Without a contract in place, Anthem patients would be "out-of-network" with Valley Health, which operates six hospitals and more than 50 medical practices and urgent care centers throughout the region. Failure to renew the contract would impact more than 55,000 local residents.

During the past few months, however, the two parties "worked in good faith to come to an equitable resolution,” and on Wednesday, April 19, both announced a settlement.

"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," Anthem Blue Cross and Blue Shield East Region President Kurt C. Small stated in a media release.

"We were pleased to be able to reach an agreement with Anthem without continuing this dispute in the courts," Nantz also stated in the release.

According to Valley Health Corporate Communications Manager, Kelly Menk, exact terms of the settlement are confidential.

"We hope our dialogue moving forward will be productive so that we can continue to serve Anthem beneficiaries into the future,” said Nantz. “The resolution of this dispute enables Valley Health to drop the lawsuit and to formally enter into negotiations to extend our current contract.”

Valley Health's existing contract with Anthem expires December 31. Negotiations for a new 2024 contract will now begin.

"We are hopeful that we will arrive at mutually-agreeable terms well before the expiration of the current agreement," said Menk.

Valley Health previously came close to parting ways with Anthem in 2020 over reimbursement negotiations. However, in that dispute, issues were resolved and the contract between the two parties was renewed.