Anthem, operating under the name Elevance Health, has announced a new policy that will take effect on January 1, 2026. The policy will impose penalties on hospitals that utilize out-of-network specialists, even when those specialists are deemed medically necessary or are already part of the hospital"s staff.
This decision is expected to impact the way hospitals manage their specialist referrals and could lead to significant changes in patient care protocols. The specifics of the penalties and the criteria for determining medical necessity have not been disclosed.
As previously reported, similar situations have arisen in other sectors of healthcare, raising concerns about access to necessary medical services. The implications of Anthem"s policy may resonate beyond immediate healthcare practices, reflecting broader trends in healthcare management and insurance policies.
For more information on related coverage, see recent developments in healthcare policy.
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