SACRAMENTO (May 4, 2026) — The California Hospital Association (CHA) has filed a lawsuit against Anthem Blue Cross to prevent the insurance giant from penalizing hospitals when Anthem enrollees choose a doctor that is out of network, a choice explicitly allowed by their health insurance plan.
The filing comes after Anthem introduced a new policy that would penalize hospitals every time an Anthem enrollee receives hospital care from an out-of-network physician — even if the hospital itself is in the insurance company’s network — by levying a 10% reduction to the hospital’s reimbursement.
“Anthem’s new policy is trying to force hospitals to solve a problem Anthem created,” said CHA President and CEO Carmela Coyle. “It’s illegal, ignores the agreements Anthem has with its enrollees, and will lead to further financial stress for California hospitals and the communities they care for during an extremely unstable period in health care.”
The lawsuit makes clear:
- Anthem’s policy unfairly penalizes hospitals — as the only remedy to avoid cuts to reimbursement would violate state law. California statute is clear that hospitals are prohibited from requiring physicians (and physician groups) to be part of any insurer’s network.
- It is Anthem’s responsibility to make certain that doctors are contracted with the insurance company, rather than foist that responsibility onto hospitals.
“We are confident the courts will recognize Anthem’s move as a flagrant attempt to increase their profits at a time when millions of Californians are projected to lose their health care coverage,” said CHA’s legal counsel Daron Tooch. “The policy is unethical and unlawful, and we look forward to a decision from the court that protects not just hospitals, but also Anthem enrollees who trust that their insurance company will respect their right to choose their own doctor.”