PORTLAND, Maine — Labor unions representing tens of thousands of people are voicing their frustrations about MaineHealth's announcement that it will no longer accept Anthem insurance at Maine Medical Center in Portland beginning in 2023.
MaineHealth CEO Andrew Mueller said Wednesday the health system's flagship hospital, Maine Medical Center in Portland, will stop taking Anthem as an in-network provider on Jan. 1, 2023.
Mueller said Anthem owes MaineHealth $70 million in unpaid claims and is withholding an extra $13 million in disputed costs. Anthem said the $13 million is because of MaineHealth overcharges for services.
An Anthem spokesperson said a routine review in 2018 discovered overbilling by Maine Medical Center for anesthesia and operating room services.
"MaineHealth eventually relented and issued refunds to our members for the amount they were overcharged. These overcharges amounted to nearly $20 million to our members. If it were not for our audits, these overcharges may never have been discovered," Stephanie DuBois, director of public relations for Anthem Blue Cross and Blue Shield in Maine, wrote in an emailed statement.
According to Gov. Janet Mills' office, Anthem covers about 300,000 people in Maine. It is the largest insurer in Maine.
On Thursday, two of Maine's largest labor unions called the contract dispute "outrageous" and "very concerning."
The Maine Service Employees Association has more than 13,000 members who work in city and county governments, the three branches of Maine's state government, and elsewhere. State of Maine employees have Anthem for their insurance.
MSEA president Dean Staffieri said in an emailed statement:
“We’re extremely concerned by Maine Medical Center’s announcement that they will remove Anthem patients from in-network health coverage starting Jan. 1, 2023. It would be outrageous for Maine workers, particularly those in southern Maine and those who need the specialty care that Maine Medical Center provides, to pay substantially more for their healthcare as a result of this corporate dispute. Hundreds of thousands of workers across Maine who already are struggling to make ends meet now have to worry about whether they will be able to afford the care they need. We urge the CEOs of Anthem and Maine Health to start putting themselves in our members’ shoes and act swiftly to resolve their dispute. We’ve begun to discuss the potential impact to our members with Anthem and the State. In the meanwhile, we are exploring every option available and we will keep our members informed as we learn more.”
Staffieri declined an on-camera interview.
The Maine Education Association, which represents teachers, also has a Benefits Trust (MEABT). It recommends about 68,000 members.
MEABT Executive Director Jennifer Kent said in an email:
"On behalf of our members, we are very concerned about Maine Medical Center’s notice of intent to terminate its provider network contract with Anthem at the end of the year. We have been in contact with both parties and have expressed our concerns and continue to encourage both sides to work out their differences and resolve this dispute. Termination of this contract would be unprecedented and harmful not only to our members but to a large percentage of the residents of Maine, in general. We continue to hope that both parties will put the interests of the their patients and their members first and use their best efforts to reach an agreement and keep Maine Medical Center in the Anthem network."
In a statement on its website, the MEABT said it received notice of MMC's termination of the contract moments before it was released to the press.
"We can only assume that the lack of notice from MMC was intentional," the statement said. "The Trust and its advisors are monitoring this situation and will also work on contingency plans in the event an agreement cannot be reached. The impact of MMC leaving the Anthem network would have a huge impact on our members and on a large percentage of the residents of Maine, in general."