Bill to ensure access to local health care moves forward
AUGUSTA – Legislation that would require the Maine Bureau of Insurance to clearly specify the criteria used when they evaluate insurance company proposals earned a positive vote Thursday from the Insurance and Financial Services Committee.
AUGUSTA – Legislation that would require the Maine Bureau of Insurance to clearly specify the criteria used when they evaluate insurance company proposals earned a positive vote Thursday from the Insurance and Financial Services Committee.
The committee voted to recommend two slightly different versions of the bill to the entire Legislature to decide how to clarify the application criteria and whether insurers should be required to clearly disclose the network of providers available in the plans.
Reps. Bobbi Beavers, D-South Berwick, Paul McGowan, D-York, and Deane Rykerson, D-Kittery, along with other York County legislators, urged this legislation forward after York Hospital was left off of the in-network hospital list in an application submitted by Anthem Blue Cross Blue Shield in August. Once approved by the bureau, anyone purchasing that plan would not be able to use that hospital for care.
“This arbitrary review process resulted in a network including 32 of 38 Maine hospitals,” McGowan said. “While other hospitals in southern Maine are included, York Hospital is not. This is problematic for the residents in the most southern part of York County.”
The lawmakers noted that the bureau sent out a bulletin recently warning consumers that they should check whether or not their provider or hospital of choice are part of the plan’s network, before finalizing their purchase.
The lawmakers noted that the bureau sent out a bulletin recently warning consumers that they should check whether or not their provider or hospital of choice are part of the plan’s network, before finalizing their purchase.
“When a consumer is buying health insurance, they are concerned with price,” McGowan. “Who would think that their local hospital would not be on the list?”
Local lawmakers testified that York Hospital is one of the area’s largest employers and provides first-rate preventative, emergency and long-term care through the hospital and their satellite facilities.
“Our concern is for the health care consumers in the very southern Maine area who may have to switch physicians and travel out-of-town for procedures,” Rykerson said. “This narrow network could also have a significant negative impact on the financial viability of this very critical health care provider and our communities.”
The group is pushing for more scrutiny in the review process by clarifying the criteria under which the plans are evaluated.
“Transparency is needed here,” said Beavers. “The criteria must be fair and applicants should know what they will be judged on. The six hospitals left off of the list should know why. And the people purchasing these plans should know if they can access their provider of choice.”
The bill will now be considered by the full House and Senate.
“Our concern is for the health care consumers in the very southern Maine area who may have to switch physicians and travel out-of-town for procedures,” Rykerson said. “This narrow network could also have a significant negative impact on the financial viability of this very critical health care provider and our communities.”
The group is pushing for more scrutiny in the review process by clarifying the criteria under which the plans are evaluated.
“Transparency is needed here,” said Beavers. “The criteria must be fair and applicants should know what they will be judged on. The six hospitals left off of the list should know why. And the people purchasing these plans should know if they can access their provider of choice.”
The bill will now be considered by the full House and Senate.
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