Mississippi News
Chaney announces network adequacy review of Blue Cross amid dispute
With no deal reached between UMMC, Blue Cross, Chaney announces network adequacy review of insurer
The 90-day grace period that allowed Blue Cross & Blue Shield of Mississippi customers to receive in-network rates at University of Mississippi Medical Center despite the hospital being outside the insurer’s network expired on Friday, leaving patients with no options other than seeking their care elsewhere or taking on exorbitant out-of-pocket costs.
UMMC, the state’s safety net hospital, went out of network with the state’s largest private insurer on April 1 due to disagreements over reimbursement rates and Blue Cross’ quality care plan.
The two parties agreed to enter mediation proceedings in late April, and had agreed on a mediator, Walter Johnson, by May 9, but Mississippi Insurance Commissioner says both parties are being “unreasonable,” indicating they are nowhere close to a deal.
When Blue Cross and UMMC used the mediation process to settle their contract dispute in 2018, it only took around 10 days to strike a deal.
On Friday, Chaney sent a letter to Blue Cross, informing him that the Mississippi Insurance Department will be conducting a targeted market conduct examination of the insurer to determine whether it is in compliance with the state’s network adequacy regulations.
He also released a statement saying he has received many emails and calls from Mississippians caught in the middle of the dispute, and that he is disturbed by the impact the dispute is having on them.
“This is a stark reminder that the only ones impacted by the dispute are the consumers,” Chaney said in the statement. “As your Insurance Commissioner, I am doing everything I can to ensure that individuals continue to have access to the healthcare provider of their choice with minimal disruption.”
State law requires insurers to provide reasonable access to all types of care included in the insured’s coverage plan. The concern is that without UMMC in its network, BCBS is not meeting this requirement due to the litany of specialty services UMMC provides that can’t be found elsewhere in the state.
The areas of concern that Chaney signaled out in the letter are:
- The services provided at Blaire E. Batson Children’s Hospital
- Level IV Neonatal Intensive Care Unit (NICU)
- Pediatric and Adult Congenital Heart Programs
- Children’s Cancer Care Program
- Sickle Cell Anemia Program
- Heart, Kidney, Liver and Pancreas Transplant Program
- UMMC’s relationship with Methodist Rehabilitation Center
- UMMC’s Satellite Facilities
Chaney said that MID is in the process of appointing an examiner to conduct the review. If the review finds that Blue Cross is violating network adequacy regulations, Chaney can revoke the authority of the insurer to operate in Mississippi, impose a fine of up to $5,000 per violation, or both.
It will likely be months before the review is completed and its findings are made publicly available. The Department completed a similar review of United HealthCare on Nov. 10, 2017, and the final report wasn’t sent to the insurer until nearly four months later.
UMMC spokesperson Marc Rolph declined to comment on the market conduct examination or confirm whether or not the hospital had renewed its contract with Chancellor Consulting Group, a California-based group that UMMC has been paying $50,000 per month since mid-September for help with its negotiation efforts. That contract expired Friday.
Blue Cross did not respond to request for comment by the time of publication. Earlier this week, Cayla Mangrum, manager of corporate communications at Blue Cross, told Mississippi Today that they are prohibited from discussing mediation, though there is no legal requirement to not discuss the process.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi News
Events happening this weekend in Mississippi: December 20-22
SUMMARY: This weekend (December 20-22), Mississippi offers a variety of festive events. In Jackson, enjoy Food Truck Friday, candlelight concerts, a Grinch movie screening, and Journey to the North Pole. In Ridgeland, experience Merry Bingo, Christmas on the Green, and Fleet Feet Coffee Run. Vicksburg hosts Rock the Halls, while Natchez offers a European Christmas Shopping Village. Other activities include Santa scuba diving at the Mississippi Museum of Natural Science, Million Dollar Quartet Christmas, and Magic of Lights in Brandon. Hattiesburg features Lights of the Wild and Teddy Bear Tea with Santa. Numerous holiday events are available across the state.
The post Events happening this weekend in Mississippi: December 20-22 appeared first on www.wjtv.com
Mississippi News
Attorneys seek protective order in Jackson bribery case
SUMMARY: Prosecutors in Jackson are seeking a protective order to prevent the release of sensitive information in a bribery case involving Hinds County District Attorney Jody Owens, Jackson Mayor Chokwe A. Lumumba, and City Councilman Aaron Banks. The motion aims to protect personal, financial, and grand jury information, fearing it could impair investigations and fair trial rights. The three officials face charges related to a bribery scheme involving $80,000 in bribes for approving a real estate development project. Other individuals, including former City Councilwoman Angelique Lee and Sherik Marve Smith, are also implicated, with Smith pleading guilty to conspiracy.
The post Attorneys seek protective order in Jackson bribery case appeared first on www.wjtv.com
Mississippi News
Suspect in the killing of UnitedHealthcare’s CEO struggles, shouts while entering courthouse
SUMMARY: Luigi Nicholas Mangione, a 26-year-old Ivy League graduate, was arrested in Pennsylvania and charged with the murder of Brian Thompson, CEO of UnitedHealthcare. Mangione, who expressed disdain for corporate greed and the health insurance industry, was found with a gun matching the murder weapon and fraudulent IDs. He initially gave false identification but was recognized at a McDonald’s. Mangione, who wrote a three-page document expressing anti-corporate sentiments, is being extradited to New York. His family, shocked by his arrest, expressed condolences to Thompson’s family. Mangione had no prior criminal complaints but had a history of severe back pain.
The post Suspect in the killing of UnitedHealthcare’s CEO struggles, shouts while entering courthouse appeared first on www.wjtv.com
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