Cincinnati-based Anthem Blue Cross and Blue Shield is reconsidering its decision to eliminate its Medicare HMO plan from 22 rural and suburban counties.
"We've agreed to reconsider, and we are working with HCFA," said Anthem spokeswoman Kendra Overbeck, who declined to elaborate.
The Ohio insurer has proposed continuing its Medicare HMO in some of the 22 counties and is discussing with HCFA adjusting premiums and copayments to make the program viable in those areas, said David DuPre, an associate administrator for HCFA. DuPre said last week that he expected a resolution by mid-September.
Anthem announced in May that it would roll back its Senior Advantage program, citing low reimbursement rates. About 20,000 of Anthem's 60,000 Medicare HMO enrollees were given until Jan. 1, 1999, to find new coverage.
The pullout would leave at least six Ohio counties with no Medicare HMO and has sparked protest from beneficiaries, a class-action lawsuit and a state Department of Insurance investigation into Anthem's marketing tactics for its Senior Advantage HMO plan (Aug. 10, p. 22).