Anthem Blue Cross Blue Shield is being praised for being a good corporate citizen in Maine thanks to the company's decision to participate in a program that proponents hope will ensure coverage for everyone in the state by 2009.

Anthem, Maine's largest health plan, is the only insurer that made a bid to participate in the Dirigo Health program.

"We're delighted," Trish Riley, director of the state Office of Health Policy and Finance, tells the Portland Press Herald. "We need only one insurer, so we're happy they're in."

There is one hitch. State officials hoped to begin offering Dirigo coverage by late summer, but that's not going to happen, says Anthem, which already insures about 500,000 state residents.

"We have said to the state [that] with the amount of internal work that would have to be done, it would take us probably closer to six months," Anthem spokesman Bill Cohen tells the Press Herald.

Dirigo is Gov. John Baldacci's effort to make good on his 2002 campaign promise to provide coverage to Maine's 130,000 uninsured residents.

The public-private partnership would set premiums based on ability to pay and be available to people living under 300 percent of the federal poverty level. That's about $28,000 annually for a single adult and about $56,000 for a family of four.

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The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

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Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

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