Just hours after Maine Medical Center in Portland announced it would drop Anthem customers from its in-network coverage in 2023, Gov. Janet Mills said it was a “drastic, damaging move” that should be reversed.
Mills said she found the split deeply concerning, especially because Anthem is the state’s largest insurer and Maine Medical Center is the largest tertiary care hospital. State employees also receive their health coverage through Anthem, she noted.
A spokesperson for Mills did not respond to a question Wednesday about how Maine Medical Center’s decision would affect insurance for state employees.
MaineHealth CEO Andrew Mueller said Wednesday the health system had informed state officials about its decision before making the announcement.
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The termination of the network contract between Maine Med and Anthem would significantly decrease medical access for Anthem customers, especially those in southern Maine, while increasing costs, Mills said.
She called for Anthem and Maine Med to reach an agreement that will avoid Anthem customers losing their in-network access at Maine Medical Center on Jan. 1.
“Termination should be avoided at all costs,” Mills said. “As both private parties negotiate the contract, I strongly urge them to put the interests of Maine people first.”
Timothy Schott, acting superintendent for the Maine Bureau of Insurance, said it had been in contact with both MaineHealth and Anthem about “concerns” in their relationship.
The bureau, which regulates Maine’s insurance industry, cannot get involved in contractual matters, he said. However, it has encouraged both MaineHealth and Anthem to try to resolve their differences before New Year’s Day.
“The Bureau is currently considering how best to work with Anthem to ensure that it maintains an adequate network of providers so its members can get the benefits to which they are entitled,” Schott said.
Maine Medical isn’t alone in experiencing problems with Anthem.
Suzanne Spruce, a spokesperson for Brewer-based Northern Light Health, said that it had experienced delays with Anthem, including for out-of-state and Medicare Advantage claims. The health care network meets monthly with Anthem to review “outstanding issues,” Spruce said.
Maine Medical Center dropping Anthem was an unprecedented event in Maine’s recent medical history, said Maine Hospital Association President Steven Michaud.
“The fact that Maine Med did this tells you just how bad it must be,” Michaud said. “You avoid this as much as you possibly can because it impacts individuals and businesses so much.”
Michaud said other Maine hospitals could also drop Anthem following Maine Medical Center’s announcement as the “frustration” about the company was statewide and even nationwide. However, he cautioned that he had not heard of other hospitals planning to do so thus far.