Anthem's New Facility Policy Metastasizing to California

FOR IMMEDIATE RELEASE
March 11, 2026

CONTACT 
Christopher Sheeron
+1 (202) 823-2333
media@action4health.org

WASHINGTON — Starting June 1, Elevance Health, the parent company of Anthem Blue Cross and Blue Shield, plans to implement its new Commercial Facility Administrative Policy in a 12th state, California.

As we detailed in our interactive map in December, this new policy penalizing hospitals when patients receive care involving out-of-network physicians started January 1 in 11 other states: Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, and Wisconsin.

“Elevance is actively limiting care options for patients and dressing it up as cost control on hospitals, when this is a pure profit play,” said Christopher Sheeron, president of Action for Health. "If insurers are allowed to penalize hospitals for care decisions patients cannot control, we should expect more policies like this to follow."

Under the policy, Anthem assesses a 10% administrative penalty on hospital facility claims whenever a nonparticipating physician is involved in a patient’s care. Elevance has also indicated hospitals could be removed from its network for continued use of out-of-network physicians.

Sheeron continued, "California's patients will pay the price of this Anthem policy through delayed care, fewer specialists, and weaker local health systems. Unfortunately, this policy spreading to California also means Anthem now plans to bypass the bipartisan No Surprises Act in the nation's largest state."

This announcement comes at the same time Anthem Blue Cross of CA increased 2026 premiums by up to 17.8%, and Blue Shield of CA increased premiums for some of its benefit plans by up to 25.3%.

Sheeron added, "Should this policy continue unfettered across the country? Should Elevance's Board of Directors start to question Gail Boudreaux's decision-making? If good governance does not prevail, then smart government will. When faced with the same policy, Indiana's legislators recently stepped up and enacted legislation to block this egregious policy. We hope Sacramento follows suit."

Last month, Indiana lawmakers passed Senate Bill 189 banning health insurance companies from penalizing hospitals for using out-of-network providers. This new measure directly rebukes Elevance's policy in its home state. According to the Indiana Hospital Association, Elevance controls approximately 68% of the state's commercial insurance market.