Maine hospitals and the Catholic Health Care System with major insurers have failed to reach a deal even as new contracts are about to expire, leaving about 14,000 patients stranded for months. there is
A contract between Covenant Health, a Catholic medical institution in parts of New England and Pennsylvania, and insurance companies Anthem Blue Cross and Blue Shield expires on Tuesday. The insurer said the discrepancy had not been resolved as of Monday.
Doctors at Covenant Health, including St. Joseph Health Care in Bangor and St. Mary’s Health System in Lewiston, will begin working with Covenant on Wednesday, said Stephanie DuBois, spokeswoman for Anthem Blue Cross and Blue Shield in Maine. He said he would be leaving the health doctors.
If conflicts cannot be resolved, patients in Maine face difficult decisions. About 14,000 people have access to services at risk.
For example, copayments and other costs may increase if patients want to continue to see their primary care physician for many years. Some people may not be able to afford the price increase, so they may be forced to find a new provider or facility, or may decide to change insurance companies.
Anthem encourages members to make appointments with other health care providers in their area, such as Northern Lights Health Care Facility in Bangor and Central Maine Health Care Facility in Lewiston.among them latest updatethe insurer warned that costs “could rise dramatically” if Covenant pulled out of its network.
Dubois said there are exceptions for Anthem members who have complex medical conditions and are being treated at Covenant medical facilities. Pregnant and terminally ill patients, in particular, can apply for continued treatment where there is no doctor in the insurance company’s network, but this is for a limited time, usually 90 days, he said.
The companies said the expiry of the contract will not affect emergency care.
and statement Covenant Health, announced at around 5:30 p.m. Monday, wrote a letter to patients saying they were disappointed that a resolution could not be reached with Anthem before the contract expired, with insurers located in Bangor and Bangor. Covenant said it would likely remove 225 of its partner providers from its network. Lewiston.
“This is not the result we wanted or anticipated when we began discussions with Anthem Main last October,” said a statement released by spokeswoman Karen Sullivan. It says it does not reflect hours of negotiations and compromises offered.
among them Updated June 1Covenant Health alleged that Maine’s low-cost, high-quality providers wanted Anthem to pay them consistent with market rates paid to other facilities and providers of similar services.
Anthem made an offer to Covenant Health to keep the company in its network, including an increase in line with current and historical inflation, but it was rejected, Mr. DuBois said.
Covenant Health “continues to push for double-digit rate hikes that are more than three times the rate of inflation,” he said, which would put a strain on employers and union members in Maine.
Sullivan disputed the allegation, saying Covenant Health had asked Anthem to “increase rates appropriately given the overwhelming rise in labor costs and inflationary pressures.”
covenant health I wrote in my previous update The insurer’s parent, Elevance Health, said it was disappointed with the terms and rates offered by Anthem. report Earnings for the first quarter of this year were nearly $2 billion.
Ansem advised patients to call the member services phone number on the back of their ID cards if they had any questions. Covenant Health referred them to the Maine Department of Health. website. If you have any questions about your patient’s condition, please call 207-907-1682 in Bangor and 207-753-4995 in Lewiston.
