3+ mon, 3+ day ago (607+ words) Northern Light Health has reached a deal with Community Health Options that the nonprofit insurer says will lower the cost of care for its 34,000 policyholders in Maine. Joanne Lauterbach, Community Health Options" chief financial officer, wrote in an email that members seeking services at Northern Light Health"s nine hospitals and more than 100 health care facilities also will see a more efficient payment method. This will make it so "a patient"s entire hospital stay is approved once they are admitted and diagnosed with a condition," Lauterbach said, requiring less back-and-forth for prior approvals. "Members don"t have to wait in the hospital for tests or procedures to be approved, and providers can move forward with necessary care," she wrote. "There are fewer delays, and less administrative costs, leading to increased efficiency for all involved." Northern Light Health"s providers…...

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…...

1+ mon, 4+ week ago (552+ words) Northern Light Health and Anthem Blue Cross Blue Shield agreed Wednesday to resume contract talks and keep the insurer's patients from being out-of-network for some health care services. The two sides said they will resume negotiations for a contract, which will determine how much Anthem pays for Northern Light's services. Under the previous contract terms, Northern Light would have been out-of-network for physicians, specialists and walk-in clinics starting on Wednesday, and for hospital services starting on Dec. 31. After Wednesday's deal, the contract for non-hospital services has been extended and now ends Oct. 31. The agreement allows "both parties to continue working toward a long-term agreement that prioritizes affordability, patient access, and quality of care," according to a joint statement from the insurance carrier and hospital network. The two sides have been negotiating for months and in a formal mediation process since…...

2+ mon, 3+ day ago (497+ words) The contract dispute between Northern Light Health and Anthem Blue Cross Blue Shield heated up on Friday, with the hospital system's president responding to accusations from the insurer about the status of the talks. The crux of the negotiations is how much Anthem would pay Northern Light's health care providers. The two sides are in a formal mediation, but Anthem has accused Northern Light of walking away from negotiations. The hospital system disputed the claim and said it is committed to reaching an agreement. If the two sides fail to reach an agreement, Northern Light's health care providers would be out-of-network for about 30,000 Anthem patients. That would increase out-of-pocket costs for patients insured by Anthem if they continue to get health care from Northern Light " the state's second-largest hospital system, which operates Eastern Maine Medical Center in Bangor and Mercy…...

1+ mon, 1+ week ago (175+ words) Nearly 11,900 Maine children lacked health insurance in 2023, the most recent year for which data is available. According to the U.S. Census Bureau, Maine had the highest rate of uninsured kids in New England at 4.6%. Massachusetts had the lowest rate in the region " and the country " at 1.5%. Texas had the nation's highest rate at 11.7%. Maine's child uninsured rate decreased by 1.9 percentage points from 2014 to 2023, according to an analysis by the Annie E. Casey Foundation, a national nonprofit focused on child welfare and family well-being. Maine's rate of uninsured children was 6.5% in 2014. Within Maine, Knox County had the highest child uninsured rate at 6.6% in 2023, according to census data, while Cumberland County had the lowest rate at 3.4%. More rural areas of the state generally had higher rates of uninsured children. The Maine Trust for Local News partners with Gigafact to produce fact briefs " bite-sized fact…...

4+ week, 1+ day ago (334+ words) I have lived over half of my life in Maine and I am lucky. I have always been employed and had health insurance through my employers. I have never had to worry about paying for health care my family needs. We have never experienced food insecurity or had to choose what bills to pay to [] You are able to gift 5 more articles this month. Anyone can access the link you share with no account required. Learn more. With a The Portland Press Herald subscription, you can gift 5 articles each month. It looks like you do not have any active subscriptions. To get one, go to the subscriptions page. - Click to email a link to a friend (Opens in new window) Email I have lived over half of my life in Maine and I am lucky. I have always been employed…...

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…...

1+ mon, 3+ week ago (189+ words) Maine's Budget Stabilization Fund, commonly known as the rainy day fund, reached its legal maximum in fiscal year 2025. In August, Gov. Janet Mills' office announced that the fund had grown to a record $1.03 billion, the maximum allowed by law. State statute caps the fund at 18% of the previous year's General Fund revenues. Once the fund hits the cap, any excess year-end surplus is redirected to other accounts, including the Highway and Bridge Capital program, while investment earnings are diverted to the state's retiree benefits trust. The state ended fiscal 2025 with a $152.2 million General Fund surplus. Created in 2003, the rainy day fund is primarily used to cover General Fund revenue shortfalls during economic downturns. It can also be tapped for line-of-duty death benefits and, under limited conditions, to support nonprofit food programs during emergencies. The fund's overall purpose is to provide…...

2+ mon, 1+ week ago (1714+ words) Delta Ambulance will raise its per capita rates next year by at least $20 for towns it contracts with, but that cost would increase if communities drop out of paying for the transport service. The change, announced Wednesday morning at the China town office, raised questions about whether municipalities will begin transporting patients to hospitals themselves rather than paying the increasing fees to Delta, a nonprofit that provides transport services to 13 towns in Kennebec, Somerset and Lincoln counties." Most of the area's fire departments provide emergency medical services to residents but lack a license or ambulance to transport patients to the hospital. Instead, first responders supply basic or advanced care on scene while waiting for Delta, which has served the region for more than 50 years. The service started charging communities with fees two years ago to address budget shortfalls caused by…...