MEASURE TO REQUIRE TRANSPARENCY IN HOSPITAL RATINGS RECEIVES PUBLIC HEARING

Posted: January 29, 2014 | Senator Craven, Senator Hill

Senator Hill introduces bill to increase accountability in creating narrow networks  

 

AUGUSTA—Yesterday, Democratic Senator Dawn Hill of York introduced a measure to require health insurance providers to have a fair, transparent process when determining which hospitals will be “in network” hospitals.

 

“This is a matter of fairness,” said Senator Hill. “Insurance companies should be up front about which hospitals they are including in their networks and why. This is a reasonable request to ensure patients and providers are informed about decisions that have a tremendous impact on Maine people and their medical care.”

 

In developing health insurance plans to be offered in the new marketplace created by the Affordable Care Act, Anthem Blue Cross Blue Shield excluded six hospitals from their list of “in network” hospitals. The six excluded hospitals are York Hospital in York, Parkview Adventist Medical Center in Brunswick, Mercy Hospital in Portland, Central Maine Medical Center in Lewiston, Rumford Hospital in Rumford, and Bridgton Hospital in Bridgton.

 

“There were no negotiations, no ratings, no cost or quality standards,” said Chuck Gill of Central Maine Healthcare. “Anthem admitted they had no objective criteria to include thirty-one hospitals from Augusta north and to exclude six hospitals and their associated providers located in central and southern Maine.”

 

Democratic Senator Margaret Craven of Lewiston, a cosponsor of the bill, testified about the impact of the exclusion: “By eliminating Central Maine Medical Center and its affiliates from their network, Anthem is requiring people who live in vast areas of the state to ignore all of their local providers and travel great distances to get medical care.”

The Legislature’s Insurance and Financial Services Committee will hold a work session on the bill, LD 1629, “An Act to Amend the Laws Governing the Provider Profiling Program,” tomorrow, Thursday, January 30, at 1:30 p.m. in room 220 of the Cross Office Building.

 

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