Scripps Health & Anthem Negotiation

In May 2025, Scripps and Anthem Blue Cross agreed to an extension of our current contract while continuing negotiations toward a new, sustainable agreement. These negotiations remain ongoing, and the current extension in set to expire on September 30, 2026. 

While Scripps is disappointed that new terms have not yet been reached, we are actively working with Anthem to find mutually acceptable terms that will allow Scripps to continue serving Anthem members. These negotiations are complex and often take time, but our focus remains on reaching an agreement that is fair and aligned with Scripps’ mission and values. Our goal is to reach an agreement before the extension ends on September 30, 2026. In the meantime, we welcome you to schedule appointments and visit any of our locations as you normally would.

Covered California health plans are not covered by the extension and remain out of network.

Scripps is always available to answer questions. You can contact us at 1-800-SCRIPPS Monday through Friday, 7 am - 7 pm PT. We want to ensure you have the information you need to get the care you and your family need.

Call Anthem at the number on the back of your insurance card to learn about benefit and claims questions.

When a healthcare provider like a hospital or physician group agrees to accept the HMO, PPO and other plans that a health plan offers, the provider becomes a participant in the health plan’s “network.” Both parties sign a contract and agree to several things that regulate how the organizations will work together. The contract includes things like the amount the health plan will pay the provider for services that the provider gives to patients who are covered by their plans, and rules for when and if the health plan can: 

• Require patients and physicians to get approval from the health plan before receiving physician-prescribed care, or the health plan will not pay for the visit(s), test(s) or procedure(s) (this is called “pre-authorization”) 
• Deny paying a portion of, or all of, the patient’s hospital or provider’s services for a variety of reasons (denials), despite the fact that a physician ordered the care 

After caring for a patient, the hospital/physician bills each patient’s health plan for services, and the health plan applies its coverage criteria for the health care services. If the health plan approves the coverage for services, the health plan is expected to pay the hospital or physician for the patient’s care based on the agreed-upon rates in the contract. The amount that a health plan pays a hospital or physician for patient care services is called a “payment” or “reimbursement” rate. 

If the health plan does not approve the patient’s health care services, the health plan will deny the provider’s request for payment and try to justify this by saying that the patient should have received pre-authorization, or for some other reason. 

There are many other details and regulations that apply to a hospital/physician’s and health plan’s contract. Reimbursement rates, denials and pre-authorizations are the most common things that are negotiated by health plans and providers.

Scripps accepts several other health insurance plans. You can view our list of in-network health insurance plans.

*Patients with Traditional Medicare or a Medicare Supplement plan are not impacted. If you have coverage through Traditional Medicare or a Medicare Supplement plan, you can continue to visit your Scripps hospitals and physicians as you normally would.