Frisbie Hospital Threatening Legal Action Over ACA Network Exclusion

Nov 7, 2013

The head of a New Hampshire hospital is threatening legal action over being excluded from the network of providers under the federal Affordable Care Act.

Al Felgar — CEO of Frisbie Memorial Hospital in Rochester — is seeking a rehearing from the Department of Insurance over the failure by Anthem Blue Cross and Blue Shield to include his hospital and health care providers in the network of providers. If the hearing is denied, the hospital is prepared to file a lawsuit, a hospital spokesman said Thursday.

Felgar also wants access to Anthem's records about the process used to determine who participates in the network.

Anthem president Lisa Guertin has said that geography and reimbursement rate concessions drove much of the selection process.