State releases details of new Anthem health insurance plan

Posted June 19, 2013, at 9:16 a.m.

LEWISTON — The state on Tuesday released the list of doctors and hospitals that Anthem Blue Cross and Blue Shield will allow patients to use in its newly proposed insurance plan.

The provider list includes some Central Maine Healthcare medical employees, including audiologists, dietitians and nurse practitioners, but it does not include Central Maine Medical Center in Lewiston, Rumford Hospital or Bridgton Hospital as allowed hospitals.

At issue is a proposal by Anthem, the state’s largest health insurer, to partner with MaineHealth, the state’s largest health-care organization, to offer new individual and small-group insurance plans for the upcoming Affordable Care Act health insurance exchange. Thousands of Mainers could be eligible to receive federal subsidies to pay for insurance.

Anthem has asked the Maine Bureau of Insurance to keep secret much of its proposal — including the provider network — as it seeks approval for the new insurance plan.

Officials from Central Maine Healthcare, the parent organization of Central Maine Medical Center, Rumford and Bridgton hospitals, believe the public hasn’t had the time or the information necessary to comment on the proposal.

CMHC filed suit in Kennebec County Superior Court late last week against Eric Cioppa, superintendent of the Bureau of Insurance, and the Maine Department of Professional and Financial Regulation, in an effort to get provider network and other Anthem insurance plan information released to the public.

CMHC officials believe a restricted provider network would limit patient choice and force some to drop their doctors and seek medical care out of town.

The head of the insurance bureau said Monday he would release the network information at 4 p.m. Tuesday, in part because the network list must be filed publicly with the bureau by July 1 and making the information available two weeks early is highly unlikely to allow a competitor to gain advantage.

Anthem could have asked a court to block its release Tuesday, but it decided not to.

“We respect Superintendent Cioppa’s decision to make public the list of providers who will be part of the proposed product and do not plan to appeal the ruling,” Anthem spokesman Chris Dugan said shortly before the planned release.

Central Maine Healthcare spokesman Chuck Gill said it would move forward with its court action despite Tuesday’s release of information. He said he believed 70 percent of Anthem’s proposal remained unavailable to the public.

CMHC wants to know what else is in Anthem’s insurance-plan application. It also wants a judge to give the public more time to comment on Anthem’s proposal before the bureau decides whether the new insurance plan can move forward.

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