3+ week, 5+ day ago (452+ words) As negotiations continue over a new contract between Northern Light Health and Anthem Blue Cross Blue Shield on Monday, insurance officials said their patients are now out-of-network for some Northern Light health services. In a statement Saturday, Northern Light President and CEO Guy Hudson said Anthem enrollees would be considered in-network while negotiations are ongoing. Jim Turner, an Anthem spokesperson, said in a statement Monday that the contract between the two parties for non-hospital services " including physicians, specialists and walk-in clinics " ended Oct. 31, making Anthem's patients out of network for those services starting Nov. 1. The contract for hospital services ends on Dec. 31. "Northern Light Health saying they will treat patients as in-network " with no plan or agreement to do so " is a recipe for patient confusion, incorrect charges to patients, and other complications," Turner said in the written statement. Turner…...

4+ week, 1+ day ago (416+ words) Contract talks between Northern Light Health and Anthem Blue Cross Blue Shield appeared to be at an impasse Friday night, the deadline for reaching a deal to ensure in-network health coverage continues for about 30,000 Mainers. Northern Light is "unwilling" to extend the current contract past the Oct. 31 deadline, Anthem spokesperson Jim Turner said in an emailed statement Friday night. Northern Light Health, however, said negotiations were continuing and was confident a deal could be struck. "We have been negotiating throughout the day and remain confident that we can get an agreement signed in the agreed upon timeframe," said Suzanne Spruce, Northern Light Health's senior vice president. "We are disappointed that Anthem has decided to again release false information to the media as discussions are ongoing." If an agreement on the contract isn't reached or the deadline isn't extended, non-hospital services,…...

4+ week, 1+ day ago (292+ words) Contract talks continued this week between Northern Light Health and Anthem Blue Cross Blue Shield, but as of late Friday afternoon no deal had been struck, despite an Oct. 31 deadline. The contract for non-hospital services " including physicians, specialists and walk-in clinics " ends Friday, which means if there's no resolution or contract extension, Anthem patients would be out-of-network starting on Saturday. The original contract for non-hospital services would have ended on Sept. 30, but the two sides came to a last-minute agreement to extend the contract to Oct. 31, after Gov. Janet Mills becameinvolved. The contract for hospital services ends on Dec. 31. About 30,000 Anthem enrollees are Northern Light patients, including state employees and some nurses and firefighters. When an insurance company becomes out-of-network, in most cases that means patients are paying higher out-of-pocket costs, as insurance plans charge more to patients when they…...

3+ week, 3+ day ago (246+ words) Northern Light Health and Anthem Blue Cross Blue Shield'announced late Wednesday night that they have reached an agreement on a multiyear contract to keep health coverage in-network for about 30,000 Mainers. In a joint statement, the hospital system and insurance company said the contract " its exact length was not immediately clear " would be retroactive to Nov. 1. A contract between the two parties for non-hospital services " including physicians, specialists and walk-in clinics " ended Oct. 31. "Anthem is deeply committed to ensuring Mainers have broad access to the care they need at prices they can afford," Anthem President Denise McDonough said in a statement. "We're pleased to have reached an agreement that keeps Northern Light Health in-network for our members and helps us continue delivering on our promise to improve lives and strengthen the health of our Maine communities." The two sides had been…...

4+ day, 21+ hour ago (314+ words) Prime Healthcare Foundation can acquire Central Maine Healthcare as long as it does not cut hospitals or essential services, state officials said this week. Central Maine Healthcare, which owns Central Maine Medical Center in Lewiston, Bridgton Hospital, Rumford Hospital and a variety of care facilities and physician practices, has been operating at a deficit for years and lost more than $29 million in 2024, according to a letter from the Maine Department of Health and Human Services. The foundation, a nonprofit based in California that operates 18 hospitals in seven states, though none previously in Maine, has vowed to invest $150 million in the three hospitals and other facilities over the next five years. The nonprofit projects positive operating gains by 2026, following the implementation of a new electronic medical records system, insourcing of services and a medical record coding process that "reduces denials and…...

5+ day, 16+ hour ago (784+ words) SOUTH PORTLAND " Small business owners and self-employed workers said during a roundtable discussion with Maine Gov. Janet Mills and U.S. Rep. Chellie Pingree on Monday that their health insurance premiums will spiral to thousands per month if certain Affordable Care Act tax credits expire. "Out-of-pocket expenses for our family for health insurance next year will be upwards of $42,000," said Ossian Riday, 54, a self-employed software developer from Topsham. "That is basically the equivalent of buying a new car every single year." Riday, speaking at the event, which was held at Greater Portland Health in South Portland, said small business owners "need solutions for health care coverage without fear of financial disaster." The extension of some of the subsidies " called Enhanced Premium Tax Credits " was at the center of a debate that spurred this fall's government shutdown, which ended on Nov. 12 without an…...

2+ day, 1+ hour ago (760+ words) Stephen Murphy is an emeritus professor at the University of Southern Maine and a volunteer State Health Insurance Assistance Program (SHIP) counselor. Medicare's annual open enrollment period is ending soon. Until Dec. 7, beneficiaries will be urged to review, compare and, if necessary, change their health and/or drug plans for 2026. If past is prologue, about 70% of all Medicare recipients will do nothing. Why?" Satisfaction with their plans is often cited as a reason for beneficiary inaction. But this is hardly the case. Medicare coverage has become dominated by private insurance plans that can change their costs, networks, health and drug coverages, etc. every year." Increasingly, these coverage options have become more expensive, but too complicated and frustrating for most people to deal with." Hidden costs, confusing enrollment periods and a dizzying array of Medicare Advantage (MA) plans have made beneficiary…...

6+ hour, 7+ min ago (1178+ words) Mary Link loves her job as a self-employed business owner, helping to run a home improvement company with her husband, Jeremy. But the Links, like other small business owners across the state, are facing a large increase in their Affordable Care Act health insurance premiums if certain tax credits expire at the end of the year. Without them, the Windham couple's monthly health insurance bill, for the same plan, would more than double next year. Mary Link, 51, said she would be faced with going uninsured or stepping away from their business, Custom Link Home Improvement, and returning to a previous career in bookkeeping. "There's a lot of freedom, working for yourself. I've enjoyed this contracting work so much. It's what I want to do and it's what makes me happy now. Should I think about going back to a corporate…...

1+ week, 20+ hour ago (918+ words) Jeffrey S. Barkin,MD, DLFAPA, is a practicing psychiatrist in Portland and the former president of Maine Medical Association. He co-hosts "A Healthy Conversation" on WGAN. Most of us do not think much about health insurance until we need it. It is like the roof over your head. You do not look at it every day. But you notice the first leak. In America, many families are hearing those first warning drops right now. And unless we act, the whole ceiling may give way. This is not a Republican problem or a Democratic problem. Getting sick is not partisan. Losing health insurance is not partisan. Bankruptcy is not partisan. Illness does not check who you voted for, how you feel about Congress, or whether your state is red or blue. When a child spikes a fever or a parent hears the…...