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Update on Anthem Blue Cross and Blue Shield in Kentucky’s Discussions with Kentucky Breast Care

June 16, 2021

Anthem Blue Cross and Blue Shield in Kentucky is committed to making sure our members have access to high quality, affordable healthcare. One way we do this is by negotiating the rates we pay doctors and hospitals for the care they provide our members. Anthem and Kentucky Breast Care (KBC) are currently in discussions about their payment rate.

KBC remains in your network and we have received no notice that they intend to leave. They have, however, demanded that Anthem agree to a very large price increase that would raise medical costs and health insurance premiums.

We know that having in-network access to a selection of care providers is important to our members. That's why we are working toward a fair agreement that keeps KBC in Anthem's network and won't unreasonably increase our members' health care costs.

Our members and employers in Kentucky trust us to deliver access to affordable, quality healthcare. We value that trust and we take our responsibility seriously.

Here’s what is happening and what it means to you
Today, Anthem pays KBC about the same as other fully certified and qualified imaging centers in southern Kentucky. Several months ago, KBC demanded a 63 percent price increase for the same care our members receive today. We cannot agree to an increase of this magnitude because it would mean higher medical costs and insurance premiums for you and our other members. Big price increases like this have contributed to health care affordability concerns in Kentucky.

Anthem’s position
In response to KBC's demands, Anthem has offered a rate increase that is about the same as rate increases seen in the rest of the healthcare industry and other imaging centers. Our proposed increase would help make sure that members continue to have affordable access to healthcare and that KBC is paid fairly for their services.

Frequently Asked Questions

 

Q: How can I stay up to date on the status of this situation?

For the most up-to-date information, refer to this site at anthem.com/kybreastcare or call the Member Services number on your Anthem member ID card. This site will be updated as new information becomes available.

Q: Could Kentucky Breast Care leave Anthem's network? Will I need to change doctors?

Kentucky Breast Care is currently participating in Anthem's provider network, and we hope to keep it that way. However, if we cannot reach a fair agreement that does not unreasonably increase costs for consumers and employers, Kentucky Breast Care may choose to leave. If that happens, it's important to know that Anthem's network includes other breast care centers in and near Somerset.

Most health plans also offer benefits for care received at out-of-network health care providers. Members should consult their plan documents or call Anthem Customer Service to understand the out-of-network benefits offered by their health plan.

Q: What other in-network mammography centers are available in and near Somerset?

The following facilities are in Anthem’s network:

Radiology and Imaging Services of Lake Cumberland

Locations at:
305 Langdon St.
Somerset, KY
606-679-7441


75 Hail Knob Rd.
Somerset, KY
606-678-9617


Russell County Hospital
153 Dowell Rd.
Russell Springs, KY
270-866-4141, ext. 516