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Many NH hospitals cut from Anthem insurance list

State House Bureau

September 04. 2013 9:28PM

CONCORD — Anthem Blue Cross Blue Shield, the only insurer approved to offer policies on the health insurance exchange created under the Affordable Care Act, has narrowed to 14 the number of hospitals for the ACA plans that will be offered beginning Oct. 1.

Paula Rogers, the company’s governmental affairs director, said the move was made to reach affordable premium levels.

“We are well aware the concept of a narrow network is new to New Hampshire,” Rogers said. “Do we need 26 hospitals to serve our plan? We decided we didn’t.”

The network for Anthem individual policy holders who do not purchase through the exchange will be limited as well when current policies expire.

Appearing before the Joint Health Care Reform Oversight Committee Wednesday, Anthem officials said the company did a national survey and found people overwhelmingly preferred lower prices over access to health care.

Critics of the plan said it amounts to rationing health care.

“Now we are not going to have the doctor of our choice, the hospital of our choice or the plan of our choice,” said committee co-chair, Rep. John Hunt, R-Rindge.

The hospitals not in the network are Concord Hospital, Southern New Hampshire Medical Center in Nashua, Frisbie Memorial Hospital in Rochester, Alice Peck Day Hospital in Lebanon, Androscoggin Valley Regional Hospital in Berlin, Cottage Hospital in Woodsville, Littleton Regional Hospital, Monadnock Community Hospital in Peterborough, Upper Connecticut Valley Hospital in Colebrook, Valley Regional Hospital in Claremont and the state’s two for-profit hospitals, Parkland Medical Center in Derry and Portsmouth Regional Hospital.

A North Country hospital is expected to be added to increase access to maternity care in the region, company officials said. The Leahy Clinics are also part of the network.

The network plan is expected to be approved by federal regulators within the next two weeks, according to Maria Proulx, Anthem NH’s senior legal counsel. State regulators have already recommended Anthem’s offering to the federal Center for Medicaid and Medicare Services.

Insurance Department legal counsel Jennifer Patterson said the plan meets the state’s network standards, but said department rules require the details to remain confidential until it goes into effect — Jan. 1 — or when the company announces details.

The two Republican senators on the committee, Jeb Bradley, R-Wolfeboro, and Andy Sanborn, R-Bedford, criticized both the Affordable Care Act and state regulators for not being willing to discuss the details of Anthem’s planned network.

With reports of only one hospital in Coos County in the network and no access to out-of-state specialty hospitals, Bradley said, he does not understand why the insurance department could not talk about a plan it approved.

“It is astonishing to me we are going to introduce the rationing of health care in New Hampshire,” Bradley said, “and we are not talking about it.”

Sanborn said people in the state are going to be shocked at the beginning of the year.

“Here in Concord and in cities and towns large and small across New Hampshire, patients are going to have to travel farther to receive care,” Sanborn said. “It is troublesome that the executive branch knew about these network reductions back in July and, despite what they would mean to patients, still saw fit to approve these contracts.”

Several committee members noted all agree that health care costs need to be controlled. Sen. Peggy Gilmour, D-Hollis, noted limited networks were the norm when managed care plans were introduced.

Steve Ahnen, president of the New Hampshire Hospital Association, said his organization’s concerns “are patients getting the right care, at the right time, at the right place or are they having to travel great distances to get their care.”

Proulx said if specialty care is not available in the network, individuals can be referred to out-of-network providers in or out of state.

Under the Anthem plan, emergency care in non-network hospitals will be covered and patients with on-going serious illness will be able to continue their treatment.

The committee meets again Oct. 2, after the Anthem plans are approved by federal regulators and the exchange opens.

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