Blue Cross

The agreement allowing the state insurance commissioner access to the financial records of Maryland Blue Cross and Blue Shield's profit-making subsidiaries is welcome. But it is long overdue. To effectively regulate the state's largest health insurance company, the commissioner should be able to examine these subsidiaries as soon as they are created.Although the Maryland Blues' managers correctly think of their organization as a business, it doesn't have the built-in accountability normally found in American corporations.

Fred M. Gloth Jr., a retired lawyer who enjoyed sailing the Chesapeake Bay and Atlantic Ocean, died June 15 of a cardiac arrest at his Finksburg home. He was 86. The son of a businessman and a homemaker, Fred Michael Gloth Jr. was born in Baltimore and raised in Relay. He was a graduate of Baltimore County public schools. During World War II, he served with the Air Force as a pilot in the European Theater. After earning his law degree from the University of Baltimore, Mr. Gloth worked for more than 40 years as vice president of the legal department and general counsel for Blue Cross Blue Shield of Maryland.

Trying to beef up marketing and sales while refocusing his own role, Blue Cross and Blue Shield of Maryland President William L. Jews announced major management changes yesterday, including the hiring of an executive from Alexander & Alexander Services Inc.Gregory A. Devou, who was regional director of marketing and new business development at Alexander Consulting Group, a subsidiary of the insurance broker, was named senior vice president of corporate marketing...

A probe of alleged anti-competitive agreements between Blue Cross Blue Shield companies and hospitals has been expanded by the U.S. Justice Department beyond Michigan, where an antitrust lawsuit that alleged the agreements raised hospital prices was filed last year. CareFirst BlueCross BlueShield, Maryland's largest insurer, confirmed to the Wall Street Journal that it received a civil investigative demand from the Justice Department but declined to comment further. Federal and state investigators also have sent civil subpoenas to Blue Cross Blue Shield units in Kansas, Missouri, Ohio, West Virginia, North Carolina, South Carolina and the District of Columbia, a person familiar with the matter said.

When it comes to jumping into a bubbling caldron -- and thriving -- few local executives can match the record of William L. Jews. First, he pulled off a successful merger of Lutheran and Provident hospitals and saved Provident from collapse. Then he tackled the politically influential but financially ailing Dimensions health-care system in Prince George's County and restored it to profitability. Now he's about to try to rescue Blue Cross and Blue Shield of Maryland from its multitude of problems.

Blue Cross and Blue Shield of Maryland has selected a Lutherville company to manage its real estate requirements, a move the state's largest health insurer expects will save $2 million annually.The selection of MacKenzie/O'Conor, Piper & Flynn Commercial Real Estate Services ends a three-month search by Blue Cross, and is part of a larger effort to become more competitive by trimming $162 million a year in administrative costs."They were chosen because of their breadth of experience, their specific experience in the field of health care and because of their depth of knowledge about local real estate," said Patricia A. Sullivan, Blue Cross' director of corporate services.

Blue Cross and Blue Shield of the National Capital Area yesterday reported second-quarter earnings of $7.3 million, up 59 percent from the $4.6 million earned in last year's second quarter.Revenue for the quarter was $237.9 million, an increase of 2 percent from $232.2 million in the year-earlier period.The Capital plan announced earlier this year that it would combine operations with Blue Cross Blue Shield of Maryland. The insurance commissioners of Maryland and the District of Columbia are to conduct hearings on the consolidation next month.

Blue Cross and Blue Shield of Maryland Inc. is apparently seeking last-minute legislation that would allow the historically nonprofit insurer to reorganize and sell stock to investors -- a controversial plan the state insurance commissioner rejected in January as a violation of state law.Rather than submit a new plan to the commissioner, Blue Cross officials scheduled a meeting last night in Annapolis with House Speaker Casper R. Taylor Jr. to discuss changing...

A 17-month-old class action lawsuit filed by subscribers of Blue Cross and Blue Shield of Maryland came to an end yesterday when the state's highest court ruled they have no standing to sue the insurer for mismanagement.In a 35-page ruling, the Maryland Court of Appeals dismissed the subscribers' argument that they should have the same right to sue as do stockholders in a corporation or members of a co-operative. The subscribers had argued that because the not-for-profit Blue Cross has no shareholders and that its board had presided while former executives mismanaged the company, they were the only independent parties who could sue to recover the losses that resulted.

Three months after announcing the elimination of 350 jobs, Blue Cross and Blue Shield of Maryland has informed state officials of plans to cut another 233 positions as a result of contracting out information services.Company officials said yesterday that the positions -- 7 percent of Blue Cross' current work force of 3,400 -- will be eliminated upon completion of an agreement with GTE Data Services of Florida."We expect it will be finalized by March 1," said Blue Cross spokeswoman Deb Nielsen.

The article in the business section "Primary care gets a boost in pay" (Sept. 21) is an interesting concept. It would be even more interesting to see how behavioral health care is integrated into this system, in a meaningful way, since most patients who are high users of the medical system and high cost usually have a co-occurring mental illness, substance abuse and/or a cognitive/intellectual disorder as well. Revising an integrated plan of care and monitoring the patient's progress is one thing, but in order to know how effective the treatment is also depends on a quality component such as the use of specific outcome measures that are realistic and measurable.

William F. Bruther, whose career as an Annapolis ophthalmologist spanned nearly 40 years and included having served as chief of ophthalmology at Anne Arundel Medical Center, died Thursday of liver failure at the medical center. He was 70. Dr. Bruther was born in Trenton, N.J., and raised in Annapolis, where his father was chief of personnel at the Naval Academy and his mother was a registered nurse. After graduating from St. Mary's High School in Annapolis in 1957, he entered Mount St. Mary's University in Emmitsburg, where he earned a bachelor's degree in 1961 in biology.

Dr. Joseph Emmett Queen, a retired internist who was former medical director of Blue Cross and Blue Shield, died of pneumonia Sunday at Greater Baltimore Medical Center. The Mercy Ridge resident was 93. Born in Baltimore, he recalled his childhood in an autobiographical sketch. He grew up with silent movies at the Forest Theater near his Forest Park home. He carried Prohibition home-brew beer for his parents, bought a used 1927 Chevrolet for $25 in 1934 and sold it three years later to a scrap dealer for $4. He drove the car, which had a rumble seat, to the Chicago World's Fair.

Mark Curtis Medairy Sr., a retired Blue Cross sales manager, died of a blood clot Dec. 19 at St. Joseph Medical Center. The Mays Chapel resident was 85. Born in Baltimore and raised on Maryland Avenue in Charles Village, he attended SS. Philip and James Parochial School and was a 1942 City College graduate. He played varsity football and varsity lacrosse at the school and was twice named an All-Maryland lacrosse player by Baltimore sportswriters. He was later inducted into the City College sports hall of fame.

State insurance regulators announced yesterday a $125,000 fine against CareFirst BlueCross BlueShield, the state's largest health insurer, for not following state laws and regulations in its denial of claims. While some cases involved failure to pay for legitimate claims, the largest number of errors found were in claims that were denied properly, but not within the 30-day limit set by state law. "The timeliness is the thing that gives us concern," said P. Todd Cioni, associate insurance commissioner for compliance and enforcement.

John M.T. Finney III, a retired Blue Cross and Blue Shield executive who had been active in Boy Scouts, died Sunday of pneumonia at the College Manor nursing home in Lutherville. The former longtime Roland Park resident was 85. Mr. Finney was born in Baltimore and raised on Circle Road in Ruxton. He was the son of Dr. John M.T. Finney Jr., a noted Baltimore surgeon who was a founder of Union Memorial Hospital. He was a 1942 graduate of McDonogh School and attended Princeton University.

When Steve and Leslie Shaeffer's daughter, Selah, was diagnosed at age 4 with a potentially fatal tumor in her jaw, they figured that their health insurance would cover the bulk of her treatment costs. Instead, almost two years later, the Murrieta, Calif., couple face more than $60,000 in medical bills and fear the loss of their dream home. They struggle to stave off creditors as they try to figure out how Selah can keep seeing the physician they credit with saving her life. "We're in big trouble," Leslie said.