Elevance Health (formerly Anthem) plans to implement a policy on January 1, 2026, that would financially penalize hospitals for using out-of-network specialists, even when those providers are medically necessary. The policy could impose a 10% administrative penalty on facility claims and even risk termination from Anthem’s network. More than 90 medical societies and the American Hospital Association are urging Elevance to withdraw the policy, warning it could disrupt patient access, pressure physicians into contracts, and undermine continuity of care.
Anthem Potentially Penalizing Hospitals That Use Out-of-Network Providers, Effective January 1, 2026
