State officials say they will pursue punitive fines against Anthem for mismanaging a Medicare Advantage contract for state retirees, after many reported delayed mail order prescriptions, unexpected charges and long hold times.
Frustration among retirees — and state leaders — has been building since Anthem took over on Jan. 1, but it boiled over Wednesday during an Executive Council meeting.
Anthem won the three-year $69 million deal through a competitive bidding process last summer, replacing Aetna, which previously administered the program for state retirees.
“This contract and the implementation of it is massively screwed up, and the company that’s implementing the new contract is doing a horrible job, and it's not getting better fast enough,” said Administrative Services Commissioner Charles Arlinghaus, whose agency led the vetting process for the Medicare Advantage vendor.
Arlinghaus told councilors that the state would seek financial penalties from Anthem for failing to achieve performance terms spelled out in the contract. He said it is possible the state could scrap the deal altogether.
He said the state is operating its own dedicated phone line for retirees who are having issues with their Medicare Advantage services, which can be reached at 603-271-1432.
Councilors Cinde Warmington and Ted Gatsas said they heard from constituents who were facing delayed medication deliveries. Councilor Janet Stevens told Arlinghaus that someone in her district received a $1,200 bill from Anthem for services that were supposed to be covered.
“I'm very worried about those who are enrolled who may not have a support network, who are alone, may have a cognitive deficit,” said Stevens. “This is a disgrace.”
In a statement released after Wednesday’s meeting, Anthem said its priority remains serving retirees and it is working to fill home delivery prescription orders. A company spokesperson also pushed back against some of the “alarmist statements” aired during this week’s meeting including that people’s lives were on the line, and said they are disappointed in the rhetoric used by state officials.
“We have been and will continue to direct all of our efforts on providing the retirees with the support that they need and will not be distracted from that purpose,” said Stephanie DuBois, a spokesperson for Anthem Blue Cross and Blue Shield. “We will continue to work closely with the State to address this and keep retirees informed.”
