Contract Talks Raise Concerns About Commonwealth Care Insurance Costs

June 28, 2007

As reported by the State House News Service, the four plans covering individuals enrolled in the state´s heavily subsidized Commonwealth Care program are seeking rate hikes beyond the 4 percent proposed by the state Connector Authority. Jon Kingsdale said that there is "a legitimate concern" that the plans do not perceive the 4 percent proposal as "enough." The plans are the Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Neighborhood Health Plan and Network Health

Yesterday the Connector board reiterated that they believe the 4 percent increase is reasonable for the six-month contract extension they are seeking and necessary to balance the authority's projected $472 million fiscal 2008 budget.

The Connector board emphasized the importance of cost control, however, adequate rates are essential for both plans and providers that need to be appropriately reimbursed.

Connector Chair Leslie Kirwan asked Kingsdale to present the board with a schedule highlighting the time frame for a possible new bidding process if the authority cannot reach an agreement for an extension. Kingsdale said if an agreement cannot be reached for an extension, a new bidding process would be a "fallback."

Kingsdale said providers "typically expect a significant increase for the same services," which has triggered the rising cost of health care. Further criticism followed as he stated of plans that "they have established a pattern in this commonwealth and nationally . . . ever since 1999, carriers´ attitude has been gee, time is running out and you need to pay us more.&

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