Anthem Blue Cross ‘Refusing To’ Release Records Of High Priced Charges From NYC Hospitals

Anthem Blue Cross is refusing to release records needed for a report into excessive hospital charges in New York City.

The New York City Health Department’s inaugural report, aimed at addressing the excessive prices hospitals charge patients, is missing key details because Anthem Blue Cross has refused to release records.

The 263-page report, released March 14 by the city’s newly established Office of Healthcare Accountability, has significant gaps due to Anthem’s refusal to provide essential data, including the full costs of healthcare at hospitals, The New York Post reported. This information is critical for assessing whether the high prices are justified.

The study focused on payments made through the city’s health provider, Anthem Blue Cross, rather than private-sector insurance plans. Despite the city paying Anthem a hefty $3 billion annually to cover around 900,000 employees, the insurer has declined to share the necessary records.

According to the report, the city’s GHI-Comprehensive Benefits Plan, administered by Anthem, paid an average of $45,150 for inpatient services last fiscal year across New York’s top 10 hospital systems. The highest costs for full inpatient treatment were at New York-Presbyterian ($92,727) and Montefiore Medical Center ($83,573), while Stony Brook University Hospital had the lowest at $36,876.

Prices for specific procedures varied significantly, with colonoscopies ranging from $940 to $12,000 and cesarean-section deliveries costing between $7,000 and $58,000. Additionally, the city is now spending more on outpatient care than on inpatient services.

Anthem claims releasing certain pricing data would breach confidentiality agreements with hospitals that were established before a 2021 federal rule mandated hospitals to disclose their prices publicly. However, Councilwoman Julie Menin (D-Manhattan), who sponsored the 2023 legislation creating the city’s first healthcare watchdog office, remains unconvinced.

With the city’s health care insurance contract set to expire later this year, Menin stated, “The city must require full disclosure of pricing” from whichever insurer is chosen.

“It’s so distressing to see these prices,” added Menin. “It’s extremely high, and is why we need price transparency. Why should New York City be paying so much for health care? It’s sickening and unsustainable.”