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Rochester woman's health care network claim dismissed

September 02. 2014 9:51PM

CONCORD — The state Insurance Department on Tuesday dismissed the claim of a Rochester woman who said she suffered injury because her doctor at Frisbie Memorial Hospital was not included in a health care provider network offered through the state’s federally facilitated health insurance marketplace.

“Based on the evidence before me, the Petitioner has not met her burden of proof,” state Insurance Commissioner Roger Sevigny wrote in the order. “She has not shown that the Anthem Pathway network is inadequate because it does not include Frisbie.” The order also denied McCarthy’s request that the Department order Anthem to contract with Frisbie, according to a release from the Insurance Department.

McCarthy, who last month was featured in a Fox News nationally televised special on the Affordable Care Act’s impact on New Hampshire, had claimed that Anthem’s provider network for plans sold on the federally operated New Hampshire Health Insurance Marketplace cannot be deemed adequate unless Frisbie Hospital is allowed to join the network.

This year, Anthem Blue Cross Blue Shield is the sole insurance company offering plans on the Marketplace, all of them through a “narrow network” that excludes 10 of the state’s 26 hospitals in exchange for lower fees from the 16 participating hospitals and accompanying providers.

The release said that, in 2015, four additional insurance companies are likely to join the state’s marketplace and each hospital in New Hampshire is expected to be in at least three networks.

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