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Maine Med has not reconsidered its decision to split from state’s largest insurer

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Maine Med has not reconsidered its decision to split from state’s largest insurer


Regardless of a plea from Gov. Janet Mills to keep away from a cut up, Maine’s largest hospital nonetheless plans to take the state’s largest insurer out of its community within the new yr.

On April 6, MaineHealth introduced that Mainers with Anthem Blue Cross and Blue Defend would now not be capable of obtain in-network protection at Maine Medical Heart in Portland starting in 2023. That call drew outcry from Mills, who stated it was a “drastic, damaging transfer” that ought to be reversed.

However in MaineHealth’s first in depth feedback since that announcement, well being system officers stated Wednesday that they stand behind their resolution to drop Anthem and highlighted the harm inflicted by Anthem’s practices in Maine and nationwide.

“There was no indication from Anthem that it’s ready to alter its enterprise practices in a manner that will trigger MaineHealth to rethink its resolution,” the assertion stated.

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Earlier this month, MaineHealth CEO Andrew Mueller referred to as the cut up from Anthem, which won’t have an effect on every other MaineHealth amenities, an “existential” resolution — indicating that the well being system might not be capable of survive if Maine Med continued to take Anthem sufferers in-network.

The insurer owes MaineHealth greater than $70 million for providers during the last three years and has additionally been withholding funds totaling round $13 million a yr, Mueller stated.

However Anthem has responded to MaineHealth’s resolution with allegations of its personal. Firm spokesperson Stephanie DuBois stated that Maine Medical Heart has been overcharging sufferers for years, an “unacceptable” observe.

In Wednesday’s assertion, MaineHealth management stated Anthem had used billing particulars taken out of context to create a deceptive image of the hospital’s charging insurance policies.

It famous that Anthem spokespeople had used the identical tactic in disputes elsewhere. That assertion additionally referenced a choice final week by a federal arbitrator that Anthem’s observe of  denying or downgrading reimbursement claims on ER visits was illegal and breached its contract with 11 Indiana hospitals. Anthem was ordered to pay the hospitals $4.5 million.

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MaineHealth and Anthem have been negotiating by a mediator for the reason that April 7 announcement. Nonetheless, little seems to have modified since then.

Sufferers who go to an out-of-network hospital are likely to pay larger out-of-pocket charges. MaineHealth’s assertion stated it had not acquired any info from Anthem about what its plans have been for Anthem sufferers at Maine Medical Heart in 2023 regardless of a proper request.



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Maine

‘You can’t wait for perfect’: Portland mixes care, crackdown in homeless crisis – The Boston Globe

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‘You can’t wait for perfect’: Portland mixes care, crackdown in homeless crisis – The Boston Globe


But where some outreach workers see peril, Dion sees a positive.

“I’m pretty proud of it,” he said of the city’s response, including opening a new, 258-bed shelter, which city officials said had absorbed many of the homeless evicted from the camps. “Some of the nonprofit world wanted a perfect answer, but you can’t wait for perfect.”

Portland Mayor Mark Dion in the dormitory of the homeless services center.Lane Turner/Globe Staff

Crackdowns against homeless encampments have gained momentum in New England, after the Supreme Court ruled in June that communities can enforce bans on sleeping on public property. This month, the Brockton and Lowell city councils banned unauthorized camping on public property, joining Boston, Fall River, and Salem with some form of prohibition.

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In Portland, the parks are now cleaner, but the underlying problems of homelessness remain, social workers said.

“The research is pretty clear that sweeps don’t work. We’re not supportive of the encampments, either; they’re awful places,” said Mark Swann, executive director of Preble Street. “But poverty is complex, and solutions to poverty and homelessness are complex, and people like the black and white.”

After the evictions, some of the homeless found shelter and a broad range of care at the $25 million homeless services center, which opened in March 2023 on the outskirts of the city, about 5 miles from downtown. About 15 to 20 beds are available each day, city officials said, but a far greater number of homeless are sleeping downtown and elsewhere.

The 53,000-square-foot complex contains a health clinic, dental services, storage lockers, mental health counseling, and meeting rooms for caseworkers, as well as three meals a day, laundry facilities, and shuttles that take clients to and from downtown, where other social-service providers are located.

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Pushing his belongings in a shopping cart, James Dolloff recounted his slide into homelessness in downtown Portland.Lane Turner/Globe Staff

“This place saved my life,” said Michael Smith, 33, an Army veteran with post-traumatic stress disorder, who had been sleeping next to a heating vent outside City Hall before he moved to the shelter.

Clients can leave whenever they choose, but many remain for days or weeks while matches with hard-to-find housing are sought for them. No identification is required, and people are accepted even if under the influence, but substance use is not tolerated on site.

“We’ll serve 1,300 to 1,400 unduplicated individuals in a year,” said Aaron Geyer, the city’s director of social services. “I’m incredibly proud of the space we have. It had been a long time coming.”

City spokesperson Jessica Grondin said the number of homeless on the streets is smaller than the number evicted from the camps.

“Most have gone to the shelter,” Grondin said. “We will have a warming shelter in place this winter when the temperatures get to a certain level,” she added, and “outreach workers will encourage these folks to go there for the night.”

The city’s previous shelter, located downtown, had used beds and floor mats, some placed about 12 to 16 inches apart, to accommodate 154 people. In addition to the new facility, Portland operates a family shelter with 146 beds, and a space with 179 beds used by asylum seekers.

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David George Delancey, 62, a former truck driver, has been living at Portland’s upgraded shelter for more than a year. “This is probably the best place to be if you want to be safe,” he said.

Delancey is still looking for housing, which Swann, of Preble Street, said is increasingly unaffordable and has contributed to the dramatic escalation of Portland’s homelessness.

“There was a time not that long ago, about seven years ago, when it was extremely rare in Greater Portland to see somebody sleeping outside,” Swann said. “There were eight or nine nonprofits running shelters along with the city at that time, and a really robust planning mechanism. That stopped on a dime.”

David George Delancey sat in the homeless services center cafeteria.Lane Turner/Globe Staff

Under former governor Paul LePage, the state cut its reimbursement rate for general-assistance funding, which communities can use for shelter costs, to 70 percent from 90 percent, Swann said. For Portland, a tourist destination with a lively food and arts scene, that decrease squeezed its ability to serve the homeless, he added.

“People do not disappear when you do not shelter them, and almost overnight dozens and dozens of people could not find a safe place to sleep with a roof over their heads,” Swann said.

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Other reasons for the spike included the mass social disruptions caused by COVID, a shortage of housing vouchers, and a steep rise in Portland’s cost of living. The city’s real-estate prices, including rents, have soared along with an increase in gentrification.

A point-in-time survey in January 2023 by MaineHousing, an independent state agency, found 4,258 people were homeless in Maine, a nearly fourfold increase over the 1,097 who were recorded in 2021.

“The other big challenge is that Maine has a serious opioid problem, one of the highest per-capita rates in the nation,” said Andew Bove, vice president of social work at Preble Street, which has 108 beds at three shelters in the city. “Many of the people we see sleeping out, a high percentage, have opioid-use disorder.”

Opioid fatalities have declined in Portland this year, to 14 deaths through October compared with 39 through October 2023, according to police statistics. But nonfatal overdoses have increased, to 459 from 399 over the same period.

Dion said opioid use in the camps, and its related safety concerns, were important drivers of the decision to raze them.

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“There was a lot of violence and exploitation directed against women in that population,” as well as theft in abutting neighborhoods, said Dion, who was elected to the City Council in 2020. “It went from being incidental to dominating the landscape of the city. At City Hall, it sucked the oxygen from every other issue.”

On the streets, the homeless continue to congregate during the day, primarily in the Bayside neighborhood, which is home to several social service providers.

Matt Brown, who founded an outreach group called Hope Squad, said it’s painfully apparent that more needs to be done, especially with winter approaching.

“I see people here, and I can almost see putting them in a [body] bag,” said Brown, a former federal parole officer, as he walked through Bayside recently.

“The uncertainty of what’s going to happen in the next few months is really scary,” he added. “Your garden-variety citizen doesn’t know exactly what’s going on.”

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Brian MacQuarrie can be reached at brian.macquarrie@globe.com.





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Beware of these proliferating Maine rental scams

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Beware of these proliferating Maine rental scams


Housing
This section of the BDN aims to help readers understand Maine’s housing crisis, the volatile real estate market and the public policy behind them. Read more Housing coverage here.

A unicorn apartment was listed in the pricey city of Ellsworth: a 2-bedroom with all utilities included for just $700 per month.

If that sounds too good to be true, it is, and the scam was not hard to detect.

The unit was posted by an anonymous Facebook user in a local forum without a specific address. A palm tree was faintly visible through the front door in one photo. When a reporter inquired about the post, someone used a Montana company’s name and sent a link to apply for a private showing in exchange for a $70 deposit.

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A quick call to the Montana company, which deals only in home sales in that state, is not behind the scam listing. A representative said the agency gets daily calls from Facebook users around the nation telling them scammers are impersonating them.

These kinds of apartment listing scams, often seen on Facebook or Craigslist, have picked up steam in recent years as the nation’s housing crisis deepens and more have become desperate for affordable places to live. The scams often promise below-market rents in cities squeezed for that kind of inventory, meaning the fraudsters target those who are most vulnerable.

“Rental scams in a very tight market are very prevalent,” Phil Chin, a lead volunteer with AARP Maine’s fraud watch network, said. “People under the pressure of income are trying to get the best for a lower price, and seniors are always at disadvantage only because they don’t have the wherewithal to do all this checking around.”

These kinds of scams are “unconscionable” for targeting families looking for affordable housing, Attorney General Aaron Frey said in a statement. His office has received multiple complaints on the issue.

Rental-Maine-GIF

Many of the advertised units do not exist, the Federal Trade Commission wrote in an advisory. Some exist but are not for rent. One Maine homeowner recently discovered that his house was for rent on Craigslist without his knowledge, said Christopher Taub, Frey’s deputy. The ad included photos and almost got one renter to send money to a Nigerian email address.

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“Fortunately, the shopper contacted the Maine homeowner and discovered the scam before sending any funds to the scam artist,” Taub said. “Other consumers haven’t been so lucky only to arrive at their paid vacation home for the week or new apartment to find out that it isn’t for rent at all.”

Often, Facebook users are wise to these scams and will comment that they appear to be one. But Facebook allows any poster to restrict their comments, allowing many fraudulent listings to go unchecked. Neither Craigslist nor Meta, Facebook’s parent company, responded to a request for comment on scam apartment listings.

To avoid being scammed, it’s important to confirm the person listing an apartment is legitimate or from a known and trusted business before sending them money, Taub said. Call the property management company and ask lots of questions or visit it yourself, the office advised.

The Federal Trade Commission recommends searching online for the rental location’s address and the name of the property owner. If the two don’t match, that’s a red flag. If there’s no address listed at all, like the Ellsworth unit, that’s another sign of a scam.

Though Maine landlords are allowed to charge application fees, it can only be for specific reasons including a background check, a credit check or some other screening process, according to Pine Tree Legal Assistance. Frey warns against paying any such fees by cash, wiring money, sending gift cards or paying by cryptocurrency, as you can’t get that money back.

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“It’s a hard one to deal with. People are under income pressure,” said Chin of AARP Maine. “They have to be vigilant on their own, … but it’s hard to keep your wits about you when you’re facing eviction.”



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Vendors prep for Maine Harvest Festival & Craft Show this weekend

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Vendors prep for Maine Harvest Festival & Craft Show this weekend


BANGOR, Maine (WABI) – You don’t need to be a farmer to enjoy Maine’s harvest this weekend!

Maine Harvest Festival & Craft Show is returning to Bangor’s Cross Insurance Center both Saturday and Sunday.

Open from 10 a.m. to 4 p.m. both days, there will be over 80 local artisans, farmers and crafters selling a wide variety of goods, making it a perfect stop for Christmas gifts or Thanksgiving additions!

WABI got a glimpse into the Cross Insurance Center Friday as vendors prepped their booths ahead of the weekend.

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New this year: admission is free!

Organizers say it is in response to low admission numbers post-COVID and to incentivize as many people as possible to come shop local.

“At the Cross Center, we really want to celebrate our community, and we want to make sure we give people, our local vendors a spotlight to reach the community,” says Brad LaBree, Cross Insurance Center’s Director of Sales and Marketing.

The event will also give attendees a chance to participate in the Cross Insurance Center’s ticket giveaway to upcoming shows a part of their Broadway series.

LaBree says Cross Insurance Center is expecting about a 5,000-person turnout this weekend.

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