Gov. Chris Sununu assured the state Executive Council that penalties will be assessed against Anthem Blue Cross and Blue Shield for problems that state retirees have had in getting prescription drug orders properly filled since the health insurer took over the program last Jan. 1.
CONCORD — Gov. Chris Sununu said penalties eventually will be assessed against Anthem Blue Cross and Blue Shield for problems that state retirees have had in getting their prescriptions properly filled since the insurer took over management of the health insurance benefit on Jan. 1.
“None of us are defending Anthem; none of us are defending them at all,” Sununu said. “These penalties will be assessed.”
Administrative Services Commissioner Charles Arlinghaus said his agency’s focus is on getting problems resolved for the 11,000 retirees who depend on this prescription drug coverage.
Executive Councilor Janet Stevens, R-Rye, presented to the council the case of one senior who had been improperly charged $1,218 for medications.
“This is a disgrace,” Stevens said.
Later on Stevens warned, “This cannot go on and I hope we are going to take immediate action because someone is going to die.”
Arlinghaus urged councilors not to be alarmist and scare senior citizens as the state’s benefit administrators are working to take care of all individual problems.
“I don’t want to say people are at risk of dying. This contract is massively screwed up and the company in charge of this is doing a horrible job and is not fixing it fast enough,” Arlinghaus said.
In a statement, Anthem said:
“Our first priority is the retirees and ensuring they receive the care and support they need. We are filling and dispensing home delivery prescriptions and ensuring retirees receive their medications. We have established a dedicated phone line with expanded call center staffing for retirees who encounter any issues with prescription fills or refills. In addition, we established a dedicated concierge team to proactively contact State retirees who may have questions.
“We are extremely disappointed in statements that detract from the focus at hand and include alarmist statements that are not accurate. 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. We will continue to work closely with the State to address this and keep retirees informed.”
Arlinghaus said he has not ruled out any actions against Anthem, including terminating the $68 million contract with Anthem, though that seems unlikely.
“They are a horrible partner, and I am not pretending that they are not,” Arlinghaus said.
Arlnghaus said any retirees with issues should call the state benefits line at 603-271-1432 and Risk and Benefits Administrator Joyce Pittman and her team have been responding to all requests.
Last July, the Executive Council and Sununu approved naming Anthem as the sole Medicare Advantage provider for 11,000 state retirees and their dependents.
Aetna Insurance previously had provided some health care services to state retirees, with Express Scripts delivering some of the prescription drug benefits.
Under the Anthem contract, 98% of mail order prescriptions must be shipped within two business days.
Every quarter that the company fails to meet that standard, it could be fined $50,000 for each percentage point below 98.
Deputy Commissioner Catherine Keane said the agency is aware that some people are being overcharged.
“All our energy going right now is for the retirees,” Keane said.