Anthem terminated its Medicaid contract with Meridian without cause, effective August 25, 2026. Neither Anthem’s termination letter nor in meetings with Anthem’s Quality staff, identified concerns related to quality of care, patient outcomes, customer service, performance, Meridian’s reimbursement rate, or any other specific deficiency as a reason for its decision. Anthem communicated that the termination was just a business decision – despite what some Anthem representatives and the Governor’s office have reported.

Importantly, Anthem chose to terminate Meridian only from its Medicaid network, while continuing its relationship with Meridian for Anthem’s commercial and privately insured members. This distinction reinforces that the decision was driven primarily by Medicaid costs, rather than the quality of care Meridian provides or the outcomes of its patients.

Meridian is one of Indiana’s largest and longest-serving community-based healthcare organizations and Federally Qualified Health Centers (FQHCs), serving more than 70,000 patients each year across its continuum of care. As a FQHC and Community Mental Health Center (CMHC), Meridian serves a large and often medically and socially complex Medicaid population and provides comprehensive services addressing both healthcare needs and Social Determinants of Health (SDOH) – the non-medical factors that can significantly affect a person’s health, such as access to food, housing, transportation, employment, education, and other essential community resources.

For many of these patients, Meridian is not simply their doctor’s office. Patients may receive primary medical care, behavioral healthcare, dental care, pharmacy services, case management and care coordination through an integrated system. Moving a patient from Meridian isn’t necessarily just finding that patient a different doctor – it can mean breaking apart an integrated network of services supporting that patient.

The fact that Anthem continues to allow its commercially insured members to receive care at Meridian, while excluding its Medicaid members from the same system of care, is an important distinction when considering the stated “business” basis for Anthem’s decision.

When we refer to “Anthem Medicaid,” this includes the Anthem Medicaid plans currently served by Meridian Health Services:

• • Anthem HIP Medicaid – Healthy Indiana Plan: Coverage primarily for eligible low-income adults ages 19–64.
  • Anthem HCC Medicaid – Hoosier Care Connect: Coverage for eligible adults and children with disabilities or blindness, as well as certain children and young adults in foster care or receiving adoption assistance.
  • Anthem HHW Medicaid – Hoosier Healthwise: Coverage primarily for children and pregnant women.
  • Anthem PathWays for Aging: Coverage and coordinated care for qualifying Hoosiers age 60 and older.

To minimize disruption in care, Meridian is diligently working with Anthem to allow many patients, particularly those with complex medical, behavioral health and ongoing treatment needs, to continue receiving care at Meridian where permitted.

Meridian is also assisting patients who may need to transition to other providers. Some patients may qualify to continue receiving care with Anthem through an approved Continuity of Care arrangement or may have the opportunity to select another Medicaid insurance carrier that includes Meridian in its network.

As we work through this transition, Meridian will continue seeing existing Anthem Medicaid patients as appropriate, with particular attention to patients with complex and continuity-of-care needs. Meridian is not accepting new Anthem Medicaid patients at this time.

Meridian remains committed to helping patients understand their options and minimizing disruption in their healthcare.
Patients should:

• • Call Anthem at the number on the back of your insurance card to determine how the change affects your individual coverage, costs and access to Meridian providers.
  • Contact Meridian Health Services at 855-634-2439 to discuss Continuity of Care and other available Medicaid plan options that we can assist you with.
  • Contact Indiana Family and Social Services Administration (FSSA) and Governor Mike Braun’s office to express concerns about access to care and the impact this decision may have on Medicaid patients and their communities.
    • Patients may call the Governor’s Office at 317-232-4567 or visit the Governor’s online contact page, https://www.in.gov/gov/contact-mike/. Concerns may also be submitted to the FSSA Secretary at AskTheSecretary@fssa.in.gov or through the FSSA contact form.

Be advised that the responses thus far have provided inaccurate and/or incomplete information about Meridian’s payment rate and quality.

This change only affects Meridian patients with Anthem Medicaid insurance. Patients with other Anthem insurance plans are not affected and can still see Meridian in network.

An FQHC is a Federally Qualified Health Center, created to provide comprehensive healthcare to medically underserved communities and populations that often have difficulty accessing care elsewhere.

FQHCs are different from traditional physician offices because they are designed to provide a broader system of care, including primary medical and preventive care, behavioral health and substance use treatment, dental care, chronic disease management, case management, care coordination, patient outreach and education, and assistance addressing Social Determinants of Health (SDOH).

This integrated model is especially important for patients with complex needs. Rather than expecting a patient to independently navigate multiple disconnected providers and organizations, an FQHC is designed to help coordinate services around the patient’s overall healthcare needs.

FQHCs also serve patients regardless of their ability to pay and care for a high concentration of Medicaid, uninsured and medically and socially complex patients.

Meridian has a long history of serving Indiana communities and in 2012 became the first Community Mental Health Center in Indiana to receive FQHC status, an important milestone in Meridian’s development of its integrated healthcare model.

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PPS stands for Prospective Payment System.

Federal Medicaid law established a specific reimbursement system for FQHCs. Rather than paying an FQHC the same way Medicaid pays a traditional physician office, Medicaid pays an established encounter-based FQHC rate that reflects the broader cost and scope of operating a health center serving medically underserved patients. The rate is approved by the state for each renewal application and is not determined by the organization.

This reimbursement model also helps sustain healthcare access in rural and medically underserved communities by supporting the infrastructure and workforce needed to recruit and retain physicians and other healthcare professionals in areas where recruiting providers can be difficult.

Without FQHCs such as Meridian, many rural and underserved communities would have significantly fewer healthcare providers and, in some areas, limited local access to essential medical and behavioral healthcare.

Meridian continues to pursue governmental intervention and legal remedies because Meridian disputes the validity of Anthem’s termination and their ability to provide care to all the affected individuals. Meridian is committed to preserving patient access to quality healthcare.

A key issue now being raised is Meridian’s “high” FQHC reimbursement rate or sometimes referred to as a PPS rate. Meridian did not establish this rate. The State reviewed and approved Meridian’s reimbursement rate each renewal period through the State’s established FQHC reimbursement process.

Meridian’s legal position is that the State cannot approve and recognize Meridian’s FQHC reimbursement rate and then effectively circumvent that rate by allowing a Medicaid managed care plan to terminate Meridian simply because the approved rate is considered too high.

The consequences extend beyond reimbursement. Removing a major FQHC provider from a Medicaid network can affect access, continuity of care, provider availability and the integrated services that medically and socially complex patients rely upon.

Meridian is therefore challenging both the termination and its impact on access to care for thousands of Medicaid patients.

Many Medicaid patients face challenges beyond their medical diagnosis. These Social Determinants of Health (SDOH) can include transportation barriers, food insecurity, housing instability, financial hardship, limited access to medications, behavioral health needs and difficulty finding specialists who accept Medicaid.

These issues directly affect health outcomes. A treatment plan is less effective if a patient cannot afford medication, has no transportation to appointments or cannot access healthy food. FQHCs are specifically structured to identify and help address these barriers as part of the patient’s overall care.

Many traditional physician practices are not staffed or financially structured to manage the same volume and complexity of Medicaid and underserved patients that FQHCs were created to serve.

This is why simply identifying another physician who accepts Medicaid does not necessarily replace the services an FQHC provides. The patient may need not only a medical provider, but also behavioral healthcare, dental care, case management, care coordination, medication support and assistance addressing SDOH.

Removing one of Indiana’s larger FQHC systems from a Medicaid network affects much more than individual physician visits.

Potential impacts include:

• • Rural and underserved patients may have fewer options for care and may need to travel farther -possibly to other counties – to find another Medicaid provider.
  • Longer wait times and gaps in care may occur as patients attempt to establish care with new providers.
  • Medical, behavioral health and dental care, case management, and care coordination may become fragmented for patients who currently receive multiple integrated services through Meridian.
  • School-based healthcare services may be disrupted, including support for children with complex medical needs who require medications, insulin management, catheter care or other healthcare support during the school day.
  • Vulnerable children and families may experience disruption to Child Advocacy Center and trauma-related programs.
  • Behavioral healthcare disruptions may increase the risk of crises. Without timely access to therapy, psychiatric care and medications, some patients may require emergency care, hospitalization or interaction with law enforcement.
  • SDOH barriers may become even greater. Transportation, housing instability, food insecurity, financial hardship and lack of nearby Medicaid providers already make healthcare difficult for many patients. Requiring patients to establish care elsewhere can magnify these challenges.

Moving a patient from Meridian isn’t necessarily just finding that patient a different doctor – it can mean breaking apart an integrated network of services supporting that patient.

For many patients, particularly those with complex medical, behavioral and social needs, preserving that continuity and coordination of care is essential to achieving better health outcomes.

Meridian’s PPS rate reflects the size, scope and complexity of the comprehensive FQHC system Meridian operates.

As one of Indiana’s largest CMHC/FQHC systems, Meridian serves more than 70,000 patients each year across its continuum of care. Its integrated care model includes primary medical care, behavioral health, dental care, substance use treatment, pharmacy services, children and family services, case management, care coordination, Child Advocacy Center programs, services addressing Social Determinants of Health (SDOH), and much more. The breadth and scope of these services are reflected in Meridian’s reimbursement rate, set and approved each time by the State, not the organization.

Therefore, comparing Meridian’s PPS payment directly to what Medicaid pays a traditional physician office – or to a smaller FQHC with a different scope of services – is not an apples-to-apples comparison. A traditional physician office is generally reimbursed for specific medical services, while an FQHC maintains a much broader infrastructure to care for medically underserved and complex populations. The reimbursement supports more than the individual encounter. It helps sustain the integrated infrastructure, workforce and services necessary to care for populations that often require support before, during and after the traditional medical visit. This higher reimbursement allows Meridian to provide a number of services that operate at a loss, but are integral community services.

Most importantly, Meridian did not choose or unilaterally establish its reimbursement rate. The rate was reviewed and approved by the State through the State’s FQHC reimbursement process.

The higher rate reflects the comprehensive infrastructure required to provide this level of care – not simply the cost of a single office visit.