Anthem ends contracts with 200+ social adult day care centers in New York

Anthem Blue Cross and Blue Shield is terminating contracts with over 200 social adult day care centers in New York, with terminations taking effect between January 1 and May 1. Elevance Health, Anthem's parent company, stated that about 120 social adult day care providers remain in Anthem's network. The terminations come as state and federal investigators pursue fraud in the sector, which includes a recent $127 million Medicare and Medicaid fraud plea in New York City.

Social adult day care is a nonmedical benefit within New York's Medicaid managed long-term care program. The move, which Elevance Health described as a network review to manage healthcare resources responsibly, raises practical questions about coverage for older adults and working family members who rely on these centers. The action occurs against a backdrop of fraud investigations targeting claims payments in the sector.