June 18, 2013

Central Maine group files suit over Anthem, MaineHealth proposal

By Jessica Hall jhall@pressherald.com
Staff Writer

Central Maine Healthcare Corp., the parent organization of Central Maine Medical Center in Lewiston and other hospitals, has filed a lawsuit seeking more information about a proposed health insurance plan being created by Anthem Blue Cross and Blue Shield and MaineHealth.

The lawsuit, filed on behalf of local doctors and patients, was filed last week in Kennebec County Superior Court against the superintendent of the Bureau of Insurance and the Maine Department of Professional and Financial Regulation.

Central Maine Healthcare has asked for the public release of documents related to the creation of the Anthem-MaineHealth venture to allow the public time to review the information before a public hearing on June 28. The lawsuit asks the court for an expedited review and requests the court schedule a hearing on the issue on or before June 21.

The Anthem-MaineHealth partnership and Maine Community Health Options are the only two organizations to submit plans to offer insurance products on Maine’s health exchange under the Affordable Care Act, which goes into full effect in January 2014.

Central Maine Healthcare contends that the proposal by Anthem and MaineHealth excludes certain  doctors and hospitals from coverage. Central Maine Healthcare’s hospitals would not be covered by the plan.

Anthem and MaineHealth also are creating an accountable care organization.

Under accountable care organizations, hospital compensation is based on how well the health centers keep patients healthy. Accountable care organizations typically allow hospitals to benefit from any savings and remain liable for cost overruns.

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