BY TIM BONFIELD
The Cincinnati Enquirer
Add Ohio Gov. George Voinovich to the list of politicians blasting Anthem Blue Cross & Blue Shield for deciding to drop about 20,000 rural Ohio residents from its Medicare HMO.
In a letter dated June 25, Mr. Voinovich criticizes Anthem's decision to drop its business in all or parts of 22 Ohio counties. He also criticized the initial response he received from Keith Faller, Anthem's president and chief executive.
"In particular, what seems to be paramount in your decision process, but not directly stated in your response, is that Anthem appears simply to have made a bottom-line business decision," Mr. Voinovich wrote.
The Voinovich letters come in addition to calls from Sen. Mike DeWine and Rep. Rob Portman for Anthem to reconsider its move. So far, Anthem has not changed its decision, but it has promised to hold more public meetings for seniors to figure out how to rearrange their health coverage.
In late May, Anthem announced it was dropping all of its customers in 19 counties, plus parts of three others, including Brown, Clinton, Highland and northern Warren counties -- effective Jan. 1.
The reasons: Medicare reimbursement rates (which vary from county to county) were too low, and future increases had been capped by the Balanced Budget Act of 1997. In addition, the development of outpatient surgery centers, home health agencies and other medical "infrastructure" in rural Ohio had been slower than Anthem expected.
In a June 16 letter to Mr. Voinovich, Mr. Faller wrote that Anthem could have waited until November to notify seniors of its plans. "In order to give them the maximum amount of time to consider and evaluate their options, notifications were mailed more than five months earlier than required," Mr. Faller wrote.
But Mr. Voinovich was not satisfied with Mr. Faller's response. He noted that Anthem continued selling its product well after the balanced budget act was passed in August.
"If the change in funding methodology was so crucial to your decision, why was a decision to pull out of the affected counties not made earlier?"
In addition, Mr. Voinovich questioned why Anthem brought up the infrastructure issue.
"Surely Anthem didn't believe that by offering the Senior Advantage product in these counties that, suddenly, entities would rush to build these urgent care facilities and surgical centers," he wrote.
Anthem spokeswoman Lauren Green-Caldwell said the company was reviewing the latest letter from Mr. Voinovich. Anthem also has not responded publicly to the letters from Mr. DeWine and Mr. Portman.
Regulators have said there is little they can do about Anthem's decision. The Ohio Department of Insurance lacks legal authority to require any insurer to market within a specific area, said Kip May, the department's deputy superintendent.
The Associated Press contributed to this report.
