Harvard Pilgrim Health Care To Take Over Maine DirigoChoice Program

September 13, 2007 – 8:53 pm | posted in Health Insurance

Not-for-profit Harvard Pilgrim Health Care starting Jan. 1, 2008, will provide coverage for Maine’s DirigoChoice program beneficiaries, state health officials announced on Thursday, the Portland Press Herald reports. The announcement came one day after state officials announced that they would not renew the contract with Anthem Blue Cross Blue Shield, which asked the state to extend a contract provision that minimized the risk of providing benefits under the program (Huang, Portland Press Herald, 9/7).

When DirigoChoice was launched in 2005, the state made an $8 million “experience modification payment” to Anthem and then made a $14.9 million payment in 2006. No payment program is in place for the current year, the Press Herald reports. According to Trish Riley, the state refused Anthem’s request for additional payments because it would have significantly raised program costs (Murphy, Portland Press Herald, 9/6).

Under the two-year contract with Harvard Pilgrim, benefits and the size of subsidies will not change. Dirigo Health, the agency that oversees the program, said premiums would increase next year regardless of the coverage provider. Information on Harvard Pilgrim’s physician network under the DirigoChoice program will be decided over the next several weeks pending approval by the Maine Bureau of Insurance (Portland Press Herald, 9/7).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy.

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