Anthem/Blue Cross Sued Over Direct Payments to Patients

Anthem and its Blue Cross entities have been sued by Sovereign Health for allegedly paying patients directly, to compel health care facilities and providers to join the health insurance network and accept lower payments.

The lawsuit in federal court accuses Anthem of giving more than $1.3 million to patients treated for addiction and mental health disorders instead of paying the facilities that treated the patients, CNN reported.

There are a number of problems in giving the payments directly to these patients, according to Lisa Kantor, one of the lead attorneys representing Sovereign Health.

"One of the things we have to worry about is that kind of money getting into the hands of someone who has an addiction problem," Kantor told CNN.

Another problem is that the facilities have to try to collect the money from the patients, which can be difficult.

Having insurers send money directly to patients is "insane," according to Arthur Caplan, director of medical ethics at New York University's School of Medicine.

"My overall, moral reaction is: Are you kidding me?" he told CNN.

"Only in our crazy, market-driven, bureaucratic mess of a system would we think about this kind of a solution," Caplan said.

Anthem declined comment for the story, CNN reported.

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