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Senate passes bill to regulate how health insurance companies decide what procedures, drugs to cover

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The Mississippi Senate this week unanimously passed a bill to regulate how insurance companies decide which medical procedures or prescription drugs to for a consumer — a called “prior authorization.”

Senate Insurance Committee Chairman Walter Michel said the legislation grew out of complaints he received from both physicians and insurance companies about how the authorization process currently works.

Prior authorization is when physicians have to seek advance approval from an insurance company before the company covers a prescribed procedure, service or medication that is not an emergency.

If an insurance organization denies a prior authorization claim, a consumer could be forced to pay for a prescription or medical procedure out of pocket.

“What we don’t want to happen is an adversarial relationship between a doctor and a patient,” Michel told reporters. “It’s to everyone’s advantage to get the prior approval from the insurance company to know the procedure is going to be paid for.” 

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Insurance companies typically believe prior authorization helps ensure doctors only medically necessary services, while doctors argue the process is typically handled by clerical insurance staffers ill-equipped to understand medical procedures.

The Senate proposal would require insurance companies to create a “portal” or website by January 2025 for doctors to submit prior authorization applications.

For emergency services like treating a heart attack, prior authorization is not required. For urgent services or procedures that can treat someone in intense pain, insurance companies have 24 hours to process requests. For non-urgent services, insurance companies have five days. 

The state Insurance Commission is responsible for regulating the program and can fine people up to $10,000 for violating the .

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Republican Insurance Commissioner Mike Chaney told that he can “ with” the Senate proposal, but he would like for the Legislature to appropriate more money to the insurance commission to enforce the program.

The bill passed without any dissenting vote, and it moved to the House for more work. The House Public Health Committee passed a similar measure this week, but the entire House chamber has not yet considered the proposal.

Republican Gov. Tate Reeves last year vetoed a similar measure that the Legislature passed by a wide majority. The governor, at the time, believed the proposal would increase costs in the .

Corey Custer, Reeves’ deputy chief of staff, told Mississippi Today in a statement that the governor’s office has worked with necessary stakeholders to address some of his concerns in last year’s version of the bill.

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“The proposed legislation reflects a of compromises by many of those stakeholders,” Custer said. “Gov. Reeves looks forward to working with the legislature to move prior authorization reform through the legislative process.”

Michel, a Republican from Ridgeland who wrote the bill, believes his latest proposal satisfies the governor’s concerns from last year.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

Mike Chaney is not the first state politico to call for his elected post to be eliminated

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mississippitoday.org – Bobby Harrison – 2024-09-22 06:00:00

Insurance Commissioner Mike Chaney is not Mississippi’s first statewide official to advocate for his job to be changed from an elected post to an appointed one.

Earlier this month, Chaney called on the Legislature to eliminate the elected insurance commissioner position and instead have the ‘s insurance industry regulated presumably by an appointee of the governor who is confirmed by the Senate. Chaney said he is willing to serve for a short period of time in an appointed position.

William Winter successfully proposed to the Legislature in the 1960s that his post as tax collector be eliminated and the duties incorporated into other positions. Winter’s actions did not end his political career. He went on to serve in multiple other statewide elected post, as governor from 1980 until 1984 and is viewed as one of Mississippi’s most significant political figures.

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In the 1970s, John Ed Ainsworth ran for and was elected to the post of land commissioner with the promise he would work to eliminate the position. One of his primary goals while eliminating the position was to ensure 16th Section land was properly managed to the benefit of . He succeeded and for his troubles was defeated when he later tried to run for lieutenant governor, though he is viewed favorably by many for his work in various of state , including in developing the state’s casino industry. The duties that the land commissioner had are now handled primarily by the secretary of state.

At least four previous statewide elected posts in Mississippi are either now appointed or have been eliminated. Besides the posts of land commissioner and tax collector being eliminated, the post of Supreme Court clerk was changed in 1976 so that the nine members of the Supreme Court appoint the clerk instead of the clerk being elected by . And in the 1980s, the elected state superintendent of education was made appointed. The superintendent is now nominated by the Mississippi Board of Education and confirmed by the Senate.

While the state superintendent of education and Supreme Court clerk are in the constitution and required an amendment approved by the voters to be changed, the land commissioner and tax collector needed only action by the Legislature to be eliminated.

Currently, the statewide posts of governor, lieutenant governor, auditor, , secretary of state and treasurer are all in the constitution, so it would take a vote of the people to change how they are selected or to eliminate any of them. The positions of insurance commissioner and commissioner of agriculture and commerce would require only action of the Legislature and the governor’s signature to make a change.

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When Chaney first ran for and was elected as insurance commissioner in 2007, he said the post should be appointed. Since then, Chaney has been reelected four times. He does not plan to run in 2027 and is saying now is the time to change how the insurance commissioner is selected.

Chaney said recently he believes an appointee “can do a better job regulating the industry and protecting the consumers” than someone elected to the post.

“I have grave concerns about someone running for this as a stepping stone to another position,” said Chaney, age 80. “It is too important to do that.”

He said it “is borderline unethical” to take campaign funds from the industry being regulated.

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Chaney said in 39 states the person regulating the insurance industry is appointed instead of elected.

Mississippi has eight statewide posts — more than most states, but there are states with more. For instance, neighboring Alabama has 10, but that includes three public service commissioners, all of whom are elected statewide. Mississippi also has three public service commissioners, but they are elected regionally.

Another neighbor — Tennessee — only elects its governor statewide. The lieutenant governor is elected by the members of the Senate.

Mississippi Lt. Gov. Delbert Hosemann, who is elected statewide, recently said on Mississippi’s Today “” podcast that the Senate would look at state government structure in the coming , including whether Mississippi should elect so many positions.

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While some posts have been changed from elected to appointed, Mississippi legislators often have been reluctant to take the vote away from the people.

In the early 2000s, the House led by then-Ways and Means Chair Billy McCoy passed legislation to make the Transportation Commission appointed instead of elected. The proposal did not survive the .

But in more recent times, legislators did vote to make all local school superintendents appointees of the local boards of education.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

On this day in 1927

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mississippitoday.org – Jerry Mitchell – 2024-09-22 07:00:00

Sept. 22, 1927

Credit: Wikipedia

St. Louis native Josephine Baker became the first Black woman to star in a major motion picture. She played the role of Papitou in the French silent film, “Siren of the Tropics,” who, like Baker, found her true calling as a performer. 

The film’s led to other starring roles, an autobiography, the creation of a doll in her likeness and even a toothpaste commercial. 

At age 11, Baker had witnessed racial violence in East St. Louis, “watching the glow of the burning of Negro homes lighting the sky. We stood huddled together in bewilderment … frightened to with the screams of the Negro families running across this bridge with nothing but what they had on their backs as their worldly belongings.” 

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After working in some choruses on Broadway, she traveled to Paris, where she became the most successful American entertainer working in France. Picasso drew paintings of her, author Ernest Hemingway spent hours talking to her in Paris bars. During World War II, she aided the French Resistance by socializing with the Germans while secretly gathering information that she transmitted to England, sometimes writing the information in invisible ink on her sheet music. 

After the war, she received the Croix de Guerre, the medal of the Légion d’honneur and other medals. When she returned to the U.S., she refused to appear before segregated audiences, despite being offered up to $10,000 ($110,000 in ‘s money) to perform. She fought to prevent Willie McGee’s execution in Mississippi, and in 1951, the NAACP honored her with a “Josephine Baker Day” and a parade of 100,000 in Harlem. 

In 1963, she became the only official female speaker at the March on Washington. She adopted a dozen children in her lifetime from countries around the globe. She called her children the “Rainbow Tribe.” She played Carnegie Hall in 1973, the Royal Variety Performance in 1974 and a revue celebrating her 50 years in show business in 1975. 

After rave reviews, she died unexpectedly after experiencing a cerebral hemorrhage. More than 20,000 attended her funeral, where she received full French military honors. 

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Diana Ross portrayed Baker in her Tony-winning Broadway show, an HBO told her (for which Lynn Whitfield became the first Black actress to win an Emmy for Lead Actress in a Miniseries or Special), and she was depicted in the TV , “Lovecraft Country.” 

In 2021, Baker was inducted into the Panthéon in Paris — the first Black woman to this honor.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

On this day in 1955

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mississippitoday.org – Jerry Mitchell – 2024-09-21 07:00:00

Sept. 21, 1955

Moses Wright points at J.W. Milam as one of the kidnappers of his great-nephew, Emmett Till. Ernest Withers defied a judge’s orders and took this . Credit: Wikipedia

Moses Wright took the witness stand and identified the who kidnapped and killed his great-nephew, Emmett Till. 

“It was the first time in my I had the courage to accuse a white man of a , let alone something terrible as killing a boy,” Wright said later. “I just wanted to see justice done.” 

He worked as a sharecropper and was also a minister, whom the locals called “Preacher.” The two white men who abducted Till — J.W. Milam and his half-brother, Roy Bryant — threatened to kill Wright if he said anything. 

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“How old are you, Preacher?” Milam asked. Wright replied 64. “If you make any trouble, you’ll never to be 65,” Milam said. When the teen’s body was recovered from the Tallahatchie , Wright identified Till. Despite threats, Wright still took the witness stand. When the prosecutor asked him to point out Till’s abductors, he stood up, pointed his weathered finger at Milam and said, “There he is. That’s the man.” 

He testified that Bryant identified himself as “Mr. Bryant.” It may have been the first murder trial in Mississippi where a Black man testified against a white man. Even after the trial, the threats continued, and Wright left to join his in Chicago, where he had already sent them.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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