The California Hospital Association has filed suit against Anthem Blue Cross, alleging the insurer's authorization protocols for post-acute care leave patients stuck with long waits for discharge.
The lawsuit claims that Anthem failed to maintain an adequate network for these services and that it does not pay for additional hospital services incurred by patients who are waiting for discharge. The organization filed the lawsuit in state court on behalf of its 400 member hospitals and health systems.
The lawsuit seeks an injunction that would prevent Anthem from "engaging in these illegal and harmful business practices," according to a press release.
“California has some of the strongest laws in the nation governing insurance company practices,” said CHA President and CEO Carmela Coyle in a press release. “Regrettably, far too many insurance companies that put their bottom lines over patient care are violating these essential patient protection laws every day, hurting patients, hospitals and the public good.
"By filing this lawsuit, we are asking the court to put a stop to these illegal practices and force insurers to do what is best for patients," Coyle said.
Anthem Blue Cross is a subsidiary of Elevance Health. A spokesperson told Fierce Healthcare that the company does not comment on pending litigation.
The association pointed to a hospital survey it conducted last year that suggested about 4,500 people in California each day are stuck in hospital inpatient wards or in the emergency department while waiting for their insurers to coordinate or sign off on their discharge plans.
The survey also found that patients who see discharge delays of at least three days spend an additional 14 days in the hospital after they're cleared for post-acute care.
These delays, according to CHA, are driving an estimated 1 million days of unneeded patient care and 7.5 million hours of wasted care in the emergency department.
“It is time for the courts to hold insurers accountable by enforcing the law. Care that is delayed is care that is denied,” Coyle said.