APMA Advocates for Change in Anthem Policy

APMA leadership met with Elevance Health, the parent company for Anthem, to discuss their new Facility Administrative Policy addressing the use of nonparticipating care providers and the potential implications for podiatric physicians and patient access to foot and ankle care. The meeting followed APMA's December 2025 letter to Elevance outlining concerns with the policy that penalizes Anthem-contracted facilities by up to 10 percent for using out-of-network providers for services.

During the meeting, Elevance provided context on the policy's intent and implementation and shared data showing a significant outlier-driven increase in costs related to the Independent Dispute Resolution (IDR) process. APMA used the opportunity to underscore concerns about potential unintended consequences for podiatric physicians, hospitals, and patients if appropriate safeguards are not in place.

APMA emphasized that podiatric physicians are frequently consulted for hospitalized patients after admission, including for time-sensitive and serious conditions. APMA also discussed the need for clear guardrails and thoughtful exceptions, so medically necessary foot and ankle care provided by podiatrists is not delayed. Elevance appeared receptive to these concerns.

In addition, APMA raised broader concerns about challenges some podiatric physicians face when seeking in-network participation, including delays in the enrollment process.

APMA will continue engaging with Elevance and other payers to ensure that efforts to address cost growth do not undermine patient access to timely, high-quality foot and ankle care provided by podiatrists.

Contact the APMA Advocacy team with any questions at [email protected].