Anthem Fined Again for Delayed Claims Payments

Health insurer agrees to restitution and fine over continued issues with timely processing of provider claims.

Apr. 14, 2026 at 2:05pm

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An extreme close-up X-ray photograph revealing the intricate internal structures of a medical claims form, with glowing ghostly lines against a dark background, conceptually illustrating the complexities of the health insurance claims process.An X-ray view exposes the complex inner workings of the health insurance claims process, highlighting the need for transparency and efficiency.Richmond Today

Anthem Health Plans and its HealthKeepers managed care plan have again been fined by Virginia's State Corporation Commission Bureau of Insurance for continuing to delay paying claims on time, despite earlier promises to fix the problem. As a result, Anthem has agreed to make restitution payments totaling $346,096.12 to 1,680 consumers and 586 providers, as well as pay a $118,000 fine.

Why it matters

Timely payment of claims is a critical issue for healthcare providers and consumers. Delays in reimbursement can create cash flow problems for providers and leave patients uncertain about their coverage and costs. This is the second time in recent years that Anthem has faced penalties in Virginia for violating the state's 40-day claims payment law.

The details

The Bureau of Insurance found that Anthem's internal issues with contracting, credentialing, network status, and fee schedules had led to delayed claims payments, particularly for behavioral health providers. Anthem has promised to fix these problems going forward.

  • In July 2024, Anthem had previously paid a $300,000 fine for violating the 40-day claims payment rule.
  • In April 2026, Anthem agreed to the latest settlement with the Bureau of Insurance.

The players

Anthem Health Plans

The largest health insurance provider in Virginia and a subsidiary of Anthem Inc.

HealthKeepers

Anthem's managed care plan in Virginia

Virginia State Corporation Commission Bureau of Insurance

The state regulatory agency that oversees insurance companies operating in Virginia

Monica Schmude

The president of Anthem's Virginia operations

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What they’re saying

“This offer is being made solely for the purpose of a settlement and does not constitute, nor should it be construed as, an admission of any violation of law.”

— Monica Schmude, Virginia President, Anthem

What’s next

The Bureau of Insurance will continue to monitor Anthem's claims processing to ensure the company follows through on its promises to improve internal systems and pay claims in a timely manner.

The takeaway

This case highlights the ongoing challenges health insurers face in meeting regulatory requirements for prompt claims payments, and the importance of strong state oversight to protect consumers and providers from delayed reimbursements.