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Anthem and Yale Medicine Face Talks Deadline

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A prominent physicians group in Connecticut and health insurer Anthem face a deadline this week to reach an agreement to keep the doctors within the insurer’s network. The brinksmanship of this particular face-off is attracting the attention of lawmakers. 

Health care provider groups regularly renegotiate the terms of their contracts with insurers -- and disputes are not infrequent -- but the prominence of Yale Medicine makes this a special case.

The group represents more than 1,400 clinical faculty from the Yale School of Medicine, who between them treat thousands of patients in Connecticut and beyond.

If they can’t come to an agreement with Anthem -- the state’s largest insurer -- by October 7, they’ve said they’ll leave Anthem’s network.

The insurer said the physicians are seeking a considerable rate increase, one that will make health care less affordable for patients.

For its part, Yale Medicine said current terms don’t reflect the value it provides.

"I would urge the parties to reach an agreement," said Governor Dannel Malloy, himself an Anthem customer, when asked about the dispute.

Senate President Pro Tem Martin Looney went further, saying he thinks lawmakers should intervene to prevent potential disruption to patients.

"I am prepared to offer legislation to mandate binding arbitration in these cases," he said, "rather than leave the public in jeopardy of having a loss of coverage if there's an impasse between an insurer and a provider group."

Anthem customers who are currently in the midst of treatment from Yale Medicine physicians might be hardest hit by any permanent rift. While they can continue to see their doctors, it’s likely to cost them a lot more to go out of network.

Harriet Jones is Managing Editor for Connecticut Public Radio, overseeing the coverage of daily stories from our busy newsroom.

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