New Hampshire Insurance Department Provides Update Regarding St. Joseph Hospital and Anthem Network Dispute

CONCORD, NH (January 2, 2025) – The New Hampshire Insurance Department (NHID) is providing the public and stakeholders with an update on the ongoing and escalating contract dispute between St. Joseph Hospital in Nashua and Anthem, New Hampshire’s largest health insurance carrier.

Anthem is the largest health insurer in New Hampshire, and St. Joseph Hospital serves as a critical healthcare facility in Nashua. The ramifications of this dispute extend to tens of thousands of Granite Staters.

In August 2024, the NHID became aware of a potentially significant impasse in contract negotiations between the two entities. Negotiations have now stalled for nearly two years, primarily due to disagreements over reimbursement rates and alleged payment discrepancies. This prolonged dispute is highly unusual and concerning.

As of January 1, 2025, St. Joseph Hospital is no longer part of Anthem’s network. This development is expected to impact thousands of Granite Staters who rely on these services. Earlier this week, Commissioner DJ Bettencourt provided an update on the matter in a letter addressed to Nashua-area lawmakers and Governor Sununu.

“This disruption comes at a critical time when individuals have already made their health plan choices for 2025,” said Commissioner Bettencourt. “Patients—including pregnant mothers, dialysis patients, and those undergoing cancer treatment—face unnecessary upheaval in their healthcare continuity due to this dispute.”

Anthem is required by state law to continue paying claims at in-network rates for 60 days following notification. However, many patients require ongoing care beyond this period, making it imperative for both parties to work collaboratively to ensure smooth transitions for affected patients.

Emergency care will remain covered as in-network, and consumers are protected by federal and state laws against balance billing.

The NHID has formally requested a facilitated discussion between the parties, scheduled for next week. While the department does not have the authority to compel negotiations or agreements, it will provide data, resources, and guidance to support a potential resolution. Both Anthem and St. Joseph Hospital have indicated a willingness to continue negotiations, and the NHID is committed to ensuring that process takes place.

“I urge both parties to prioritize the health and well-being of New Hampshire residents,” added Commissioner Bettencourt. “Time is of the essence, and the consequences of inaction are serious.”

Consumers with questions or concerns are encouraged to contact the NHID Consumer Services Division at 603-271-2261 or visit https://insurance.nh.gov.

Commissioner Bettencourt’s letter can be viewed at https://insurance.nh.gov/sites/g/files/ehbemt861/files/file-type/20241231-st-joseph-update.pdf.

The New Hampshire Insurance Department Can Help

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. Contact us with any questions or concerns you may have regarding your insurance coverage at 1‐800‐852‐ 3416 or (603) 271‐2261, or by email at consumerservices@ins.nh.gov. For more information, visit https://insurance.nh.gov/.