Anthem Correspondence to Providers Regarding Parity Benefit Adjustments

December 2016

Providers may have recently received correspondence from Anthem Blue Cross (Anthem) regarding 2016 Mental Health and Substance Use Disorder Benefit Adjustments. Anthem writes that, in accordance with the Mental Health Parity and Addiction Equity Act, the Department of Managed Health Care requirements, and California law, Anthem “must revise certain mental health and substance use disorder benefits to comply with state and federal law.” In some cases, there may be additional payments to the providers if providers were underpaid. Some of that may include payment refunds to be made to patients in the event of excessive copayments or coinsurance. It is recommended for Anthem contracted providers to re-verify current Anthem insured patients’ benefits and eligibility.