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She worried Anthem would not cover her child's care amid Bon Secours lawsuit. Here's what CBS 6 found out.

Posted at 6:58 AM, Sep 22, 2023

RICHMOND, Va. -- A Virginia mom is concerned for her two-year-old daughter’s future after receiving a letter that her daughter's much-needed physical therapy intensives may no longer be covered by her family’s insurance.

This comes as thousands of Virginians who rely on Medicare through Anthem Blue Cross Blue Shield are preparing for their Bon Secours doctors and treatments to be out of network if an agreement isn’t reached between the two major healthcare operators by October 1.

Kelly-Anne Rasnake's daughter Charlotte was born with a rare genetic condition that impacts her balance. Because of that, she isn’t yet able to walk on her own yet.

Kelly-Anne Rasnake

Charlotte qualifies for Medicaid vouchers, and since January, she's been attending three-week-long physical therapy intensives at Bon Secours Richmond Hope Therapy Center, the only facility that offers this kind of treatment in the state.

"I had just shared videos with our family and friends of Charlotte standing independently for 19 seconds," said Rasnake. "And we were all like crying and so excited to see the progress that she's made. So the same day I opened the letter that said she might not be able to go, and it was like a punch in the stomach. Because this is the one treatment we've been able to find that, you know, it's truly giving us hope for her future."

Rasnake is referring to a letter Anthem sent to about 11,000 Virginians who rely on Medicare and Medicaid that explained Bon Secours could be out of network if they don't reach an agreement with Bon Secours by October 1.

The Zuni mom drives three hours a day for weeks at a time in order for Charlotte to visit Richmond Hope for two-hour sessions that last three weeks at a time.

At Richmond Hope, therapists use cutting-edge therapy techniques like dynamic movement intervention, and Charlotte has made more progress here than she has in months of traditional once or twice-a-week physical therapy.

"There is no doubt that the intensives are the best treatment that we can get Charlotte, so the idea of her not being able to go to Richmond home anymore is truly heartbreaking for us," Rasnake explained. In their name, Richmond Hope, it really has given our family hope for Charlotte's future that she will be able to walk independently."

Kelly-Anne Rasnake

Rasnake says she was initially told by Richmond Hope staff that Charlotte would not be covered by a Continuity of Care policy, but CBS 6 was able to get in touch with Jennie Reynolds, the president of Anthem Healthkeepers Plus, who explained Charlotte’s care will actually still be covered, and there are other conditions that qualify too.

"We are not going to disrupt you in the middle of a pregnancy," Reynolds said. "We will have to manage through that process. Obviously, cancer treatments that is a very personalized, individualized kind of case. And so we've got to work through those, again, any specialized cases that really require that specialization that they may be receiving from their current doctor."

CBS 6 also reached out to Bon Secours who sent us the statement below, which reads:

At Bon Secours and the Richmond Hope Therapy Center, the health and well-being of our patients is our highest priority, and we are committed to providing sustainable, compassionate, high-quality care for years to come. As the first and only faith-based clinic in Virginia to offer highly effective intensive therapy options for children, adolescents and young adults, it is our Mission to care for those who are vulnerable and we are proud to serve them in their time of need.

As of October 1, 2023, Bon Secours may be out-of-network for Anthem Managed Medicaid patients in Virginia. This follows nearly a year of negotiations with Elevance Health (Anthem) to fairly reimburse the ministry for the cost of providing high-quality care to patients. Anthem’s current reimbursements – which are substantially less than other payers – have not kept up with inflation and are overwhelmingly inadequate to account for the cost of providing safe and quality care.  

Hope Therapy patients are coming to us in an already stressful time. Changing insurance plans can help ensure Bon Secours remains in-network and patients can continue to see their trusted providers, and we are here to support patients as they evaluate options. If some patients are unable to switch insurance carriers, Continuity of Care is a provision intended to protect those patients with chronic or complex diseases from an interruption in care. 

We promise to continue doing our part and work hard to reach a new agreement with Anthem on behalf of our patients and the communities we serve – so nothing comes between our patients and the caregivers they rely on.

Virginians who rely on Medicare for treatment at Bon Secours facilities will be able to continue that care until October 1, and only if Anthem and Bon Secours can't reach an agreement by the date will Continuity of Care actually come into effect.

"We do continue to work with Bon Secours, of course, and we are trying to come to a resolution," Reynolds explained. "And all I can say is, I think for the best of everybody here in the Commonwealth, we are very anxious to get this to a resolution."

Anthem says if you want to find out if you could qualify for Continuity of Care, you should call the number on the back of your provider card to talk to a representative for Virginia.

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