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Maine.gov > PFR Home > Insurance Regulation> Administrative & Enforcement Actions > Document 54 : INS 99-14 : Hearing Decision
STATE OF MAINE
The Superintendent of Insurance is in receipt of seven applications for intervention relative to the above-captioned proceeding. Each applicant seeks intervention as of right and the Maine Medical Association seeks permissive intervention should the Superintendent find the MMA is not entitled to intervention as of right. The applications of the Maine Health Alliance, the Maine Medical Association, the Maine Ambulatory Care Coalition, and Central Maine Healthcare Corporation are GRANTED as of right. The Maine Council of Senior Citizens, Consumers for Affordable Health Care, and the Maine Peoples Alliance are GRANTED permissive intervention.
CENTRAL MAINE HEALTHCARE CORPORATION
Central Maine Healthcare Corporation (CMHC) seeks intervention as the holder of 50% of the stock of Central Maine Partners Health Plan (CMPHP), an affiliate of Blue Cross and Blue Shield of Maine. Anthem Health Plan of Maine seeks to acquire CMPHP through its acquisition of BCBSME. The Superintendent agrees that this relationship and the potential change in the governance of and the value of CMPHP could result in CMHC being substantially and directly affected by this Proceeding. CMHC is granted intervention as of right pursuant to 5 M.R.S.A. § 9054(1).
MAINE HEALTH ALLIANCE, MAINE MEDICAL ASSOCIATION, AND MAINE AMBULATORY CARE COALITION
The Maine Health Alliance (MHA) is an integrated delivery system that arranges for the provision of health care services through hospitals, primary care physicians, and specialists under contract with the MHA. In particular, the MHA includes 11 hospitals that have entered into a Hospital Services Agreement with BCBSME. The agreement is due to expire December 31, 1999.
The Maine Medical Association (MMA) is a professional association of more than 2,000 physicians throughout the State of Maine. Members of the MMA assisted in establishing BCBSME in 1938 and continue to participate in its governance. MMA members are participating physicians in BCBSMEs network of health service providers. Members and staff of the MMA participate in a group health plan underwritten by BCBSME.
The Maine Ambulatory Care Coalition (MACC) is an organization whose members consist of 26 Federally Qualified Health Centers including 24 rural community health centers. The health centers service rural areas of Maine, which are medically underserved. All of the community health centers participate in health plans offered by BCBSME.
BCBSME is the largest health carrier in the State of Maine and is accepted by virtually all health service providers within the State. As such, payments of claims covered by BCBSME plans represent a significant amount of the revenue of health service providers within Maine. While it is true, as the Applicants argue, one is not entitled to intervene as of right simply because of a contractual relationship, the contractual relationships between the providers represented by these organizations and BCBSME are so significant for these providers that the granting of intervention as of right is justified in this instance.
MAINE COUNCIL OF SENIOR CITIZENS, MAINE PEOPLES ALLIANCE, CONSUMERS FOR AFFORDABLE HEALTH CARE
The Maine Council of Senior Citizens (MCSC) is an affiliate of the National Council of Senior Citizens and, among others things, advocates on behalf of senior citizens and other health care consumers. In its application for intervention, the MCSC does not identify the specific issues that could substantially and directly affect it or its membership. Rather, the MCSC refers to general concerns which, while worthy of exploration, do not explain how MCSC or its members will be directly impacted by this proceeding in a manner similar to that of CMHCC and the provider organizations discussed above. Nonetheless, there is no denying that the pending BCBSME transactions raise novel and important issues to which the MCSC can bring enlightened points of view. Accordingly, the MCSC is granted permissive intervention pursuant to 5 M.R.S.A. § 9054(2).
Similarly, the Maine Peoples Alliance and Consumers for Affordable Health Care have failed to articulate clear, substantial and direct affects either on the organizations, themselves, or on certain of their membership. Again, each organization has identified areas of general concern, which likely represent the concerns of certain segments of the public. Both organizations, however, bring with them points of view and positions that should be explored prior to any determinations are made as to the pending transactions. Thus, the Maine Peoples Alliance and Consumers for Affordable Health Care are each granted permissive intervention pursuant to 5 M.R.S.A. § 9054(2).
As parties to the proceeding, each intervenor shall be bound by all procedural requirements set forth in Title 24-A, Bureau of Insurance Rule Ch. 350, and all procedural orders issued by the Superintendent during the course of this proceeding. The Intervenors are advised that a Procedural Order was issued on November 4, 1999. The Order should be reviewed carefully as it contains a number of requirements as to the filing and service of documents.
Given the responsibility of the Superintendent to have an effective and efficient proceeding and the similarity of interests as among certain of the intervenors, the Superintendent believes some coordination of efforts between the intervenors is warranted. The Superintendent ORDERS all intervenors, other than the Attorney General, to confer and make a written submission on or before 3:00 p.m., November 19, 1999, suggesting how the intervenors may be grouped for purposes of coordinating discovery and suggesting a process for the coordination of discovery. It is the desire of the Superintendent to avoid duplication of efforts particularly given the limited resources of some intervenors. It is also the desire of the Superintendent to avoid the service of multiple discovery requests when one or two joint requests from groups of intervenors would accomplish the same goal.
PER ORDER OF THE SUPERINTENDENT
DATED: November 12, 1999
ALESSANDRO A. IUPPA
Superintendent of Insurance
Last Updated: January 21, 2014
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