Advocates claim Anthem fine not big enough, long overdue

PORTLAND – Record fines imposed last week on Maine’s largest private insurer are long overdue and too small, consumer advocates say.

“I think the Bureau of Insurance has been much too lax on insurance companies,” said Joe Ditre of Consumers for Affordable Health Care.

“They could be doing a lot more to protect the interests of consumers in exactly this type of way.”

The state Insurance Bureau fined Anthem Blue Cross-Blue Shield of Maine and its subsidiary, Maine Partners Health Plan, $250,000 and $100,000 respectively for failing to pay interest on undisputed claims that Anthem did not pay within 30 days, as required by state law.

Anthem and its subsidiary also must pay more than $1.2 million in interest to more than 387,000 claimants to correct the violations.

Customers entitled to payments under the consent agreement will be notified by Anthem and Maine Partners, and checks will be mailed within the next 90 days.

Alice Knapp, a Richmond lawyer who once worked in the consumer health care division of the insurance bureau, said she was “delighted to see that some action was taken,” but added that the penalties against Anthem are “ridiculously small.”

Although the fines were the largest ever assessed by the insurance bureau, Maine is still far behind states such as Texas and Connecticut in cracking down on the “prompt payment” issue, she said.

“There’s a whole slew of states who have been very aggressive on that, and years ago fined companies really big bucks for that violation,” Knapp said.

The investigation began because the bureau had been getting more calls in recent years from consumers and health care providers complaining about late claim payments and lack of interest payments, state Insurance Superintendent Alessandro Iuppa said.

But Iuppa said state examiners “certainly had no inkling” of the magnitude of the problem until they began auditing Anthem, examining claims from Sept. 19, 1999 to March 31, 2002.

Anthem said the problem is the result of a computer program that was not in compliance with the prompt payment requirement. Anthem spokesman Bill Cohen said the company told the Insurance Bureau about the problem.

Iuppa said the Bureau of Insurance found the problem.

“They may have known about it, but we’re the ones who brought it to their attention,” Iuppa said.