Health Plus Of Michigan

Blues asks state for OK for wider Medicaid sales

Blue Cross Blue Shield of Michigan has asked the state for approval to sell its Medicaid policies to a broader part of Wayne County.

The request, submitted last week to Michigan's insurance regulators, shows the company is intent on growing its Medicaid business, starting on its home turf. The Blues, based in Detroit, is the state's largest insurer with more than 4.6 million subscribers.

On Tuesday, the Blues and a Philadelphia Blue Cross company announced plans to buy the AmeriHealth Mercy Family of Companies, a Pennsylvania Medicaid, pharmacy benefits and behavioral health provider firm, with hopes of selling Medicaid nationwide, possibly with other Blues plans.

AmeriHealth Mercy is one of the nation's largest Medicaid providers. But earlier this year, it had to pay $2 million to Kentucky's Medicaid program for falsifying patient quality scores in an effort to boost its reimbursements from the program.

A company statement said the people involved "no longer are with the company" and that paying the fine was not an admission of wrongdoing but more an attempt "to resolve the dispute."

The purchase is seen as significant because two-thirds of Blue Cross companies have stayed out of the Medicaid program, or, as in Michigan, played a small role in it.

But the addition of about a half-million new Medicaid enrollees in Michigan through federal health reforms under way through 2019 has made the historically unattractive and low-paying Medicaid market into what is shaping up to be a highly competitive part of the health insurance business here and elsewhere.

The Blues hopes to increase membership through its BlueCaid Medicaid program to 29,407 by September 2013, up from the 19,349 it covers in Wayne County, according to the filing from the Michigan Blues to Michigan's Office of Financial and Insurance Regulation.

Expanding BlueCaid would increase net income from $62 million now to $79.5 million, the Blues' document said. Statewide, BlueCaid has 21,000 members in Wayne, Washtenaw and Livingston counties.

Craig Bass, president of Molina Healthcare of Michigan, the state's third-largest Medicaid provider with 200,000 beneficiaries in 48 counties, said his company hopes to expand its Medicaid program and expected competition to increase because of health reforms.

Cheryl Gallon, director of Medicaid services at HealthPlus of Michigan, said she sees no reason now for other providers to be allowed to expand their Medicaid coverage, as 14 plans with good programs like hers already have contracts with the state through fiscal 2013.

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The Health plus of Michigan is greatly and nicely working into the world and also for above thirty years of the health plus has been chosen and dedicated to improve the heath of the various communities in which we live and serve each other. The Health plus of Michigan is purely for the serving and getting huge fame of the health and fitness purposes of the life of persons and for to move nicely into their duties and aims about the all lives of the all world. The Health plus of Michigan is basically providing the all benefits and advantages more then 200000 totally satisfied persons and members.

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