Greene County General Hospital (GCGH) announced today that it has served Anthem with a breach notice after months of failed efforts to resolve significant payment and adjudication issues affecting the hospital and its patients.

GCGH states that Anthem has been paying claims far below what GCGH believes is required under contract and has acknowledged that many commercial claims were adjudicated under an out-of-network framework. “Anthem has acknowledged that claims were not handled correctly, yet the problem remains unresolved,” said Brenda Reetz, GCGH CEO. “This has harmed our hospital, likely harmed our patients, and continues to put pressure on our operations.”

According to GCGH, the issue involves regular commercial claims that were processed under the wrong framework, reducing payment to the hospital and likely affecting patient financial responsibility. “This is not just about old claims,” said Reetz. “When a payer underpays below contract and processes in-network business under the wrong logic, the impact reaches patient bills, hospital stability, and access to care.” GCGH says the financial strain from Anthem’s payment practices has contributed to ongoing operating losses and has further weakened the hospital’s ability to sustain key services. “Rural hospitals cannot continue absorbing this kind of payment failure,” said Reetz. “When reimbursement is suppressed over time, it becomes harder to protect services that our community depends on.”

Despite Anthem’s acknowledgment of the issue, GCGH says Anthem has failed to provide a timely and meaningful resolution. “We have tried to resolve this directly and constructively,” said Reetz. “At some point, acknowledgment without correction is just continued harm.” GCGH is calling on Anthem to fully identify the scope of the affected claims, properly reprocess and pay them, correct any improper patient financial responsibility, and engage promptly in resolving the broader contractual issues. “Our patients and our hospital should not continue paying the price for Anthem’s errors,” said Reetz. “We are asking for accountability, correction, and action.”