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Gov. Reeves announces 11th hour plan for hospital crisis. Opponents pan it as ‘too little, too Tate’

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1 year ago

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After being criticized for months by his Democratic opponent for not having a plan to address Mississippi’s health care crisis, Gov. Tate Reeves on Thursday unveiled what he called “sweeping Medicaid reimbursement reforms.”

Reeves’ proposal, announced less than two months before the November election, includes pulling more federal dollars to increase Medicaid reimbursement to hospitals — a plan that Reeves’ own Medicaid administration advised GOP lawmakers and hospital leaders last year wouldn’t work.

Hospitals under the plan would pay an increase in “bed taxes,” but this would allow more federal dollars to be drawn down for a net to hospitals of $689 million, Reeves said. His plan also includes a measure to allow speedier prior insurance authorization of drugs or procedures, a measure lawmakers had passed but Reeves vetoed earlier this year.

Reeves’ plan does not include Mississippi accepting more than $1 billion a year in federal dollars to expand Medicaid to cover the working poor as 40 other states have done.

The governor’s plan was immediately panned on Thursday by supporters of Medicaid expansion and of his opponent, who dubbed his proposal, “too little, too Tate.” State political observers speculated Reeves’ new plan is a result of polling and of Mississippi’s GOP legislative leadership warming to the idea of Medicaid expansion.

READ MORE: Likely new Speaker Jason White says Medicaid expansion ‘will be on table’

Tim Moore, president of the Mississippi Hospital Association, on Thursday said, “Who would have ever thought donating $250,000 to a Democrat would have motivated a Republican so much?” He was referring to MHA’s PAC donating to Democratic gubernatorial candidate Brandon Presley.

Moore said he was appreciative of Reeves’ proposal, but “surprised by what was presented because they’re things we’ve proposed for years.”

“It still does nothing to help the low-wage earners in Mississippi who do not have the disposable income to pay for medical care,” Moore said. “What’s the difference in taking federal money to do this, and taking federal money to cover working poor people?”

Reeves reiterated his opposition to Medicaid expansion, which he referred to as “welfare,” as he gave a press briefing on his new plan, which would have to be approved by the federal Centers for Medicaid Services. Reeves said the plan was submitted to CMS on Thursday, and that approval or disapproval could take months.

“This will have a profound impact on the bottom line of hospitals across the state, large and small,” Reeves said Thursday. As for Mississippi’s highest-in-the-nation rate of people without insurance, Reeves reiterated that they need to get a job or better job.

“We need more people in the workforce,” Reeves said. “… I am focused on bringing better and higher paying jobs and providing opportunity for Mississippians to train for the jobs of tomorrow and have their insurance through their employer.”

READ MORE: Nearly half of rural hospitals at risk of closure in Mississippi, new data shows

Reeves’ proposal on Thursday was immediately blasted by his Democratic opponent Brandon Presley, who has made Medicaid expansion to cover the working poor with federal dollars a major plank in his platform.

“If Tate Reeves really cared about ending the hospital closure crisis he created, he would call a special session and expand Medicaid so working families can get the healthcare they need,” Presley said in a statement. “Tate Reeves has had 12 long years to do something about Mississippi’s hospital crisis and 47 days before an election is too little, too late for the hospitals that have cut essential services, lost jobs, or are on the brink of closing altogether. 

“Today’s announcement is nothing more than an election year stunt and just more proof that Tate Reeves is a craven, failed governor who will always look out for himself and his political career ahead of the health of Mississippi families,” Presley said.

Mississippi Democratic Chairman Cheikh Taylor (second right), State Rep. Daryl Porter (right) and Democrat supporters gathered at the Sillers Building to protest Gov. Tate Reeves unveiling of a hospital program, Thursday, Sept. 21, 2023. Credit: Vickie D. King/Mississippi Today

Other state Democratic leaders held a small rally outside Reeves’ office building after his announcement. They chanted, “Too little, too Tate,” and called for Medicaid expansion.

“Tate Reeves does not care about the $1 billion it would bring into our state or the 10,000 jobs it would create,” said state Democratic Party chairman and state Rep. Cheikh Taylor. “At the end of the day, Tate Reeves does not care. He cares about what his political position is in the final days of the election.”

Reeves proposal, if approved by CMS, would reimburse providers of Medicaid managed care services near the rate at which private insurers pay. It would reimburse hospitals for treating Medicaid fee-for-service patients at the upper level of what Medicare pays, higher than Medicaid’s normal rate. Hospitals would pay more in bed taxes to cover the state’s share of the higher rates, and lose some federal payments for treating uninsured patients, but would net an estimated $689.5 million, Reeves said.

Republican legislative leaders and the hospital association starting last year pushed a similar proposal to increase Medicaid reimbursements to hospitals, but were told by Reeves’ Medicaid administrators that it wouldn’t work — and would only bring in about $40 million — because the state’s rate of commercial insurance payments are so low.

When asked about this on Thursday, Reeves deferred the question to Medicaid Director Drew Snyder, who cryptically answered that the difference in projections this year versus last year is because, “We got the right people in the room.”

Republican Lt. Gov. Delbert Hosemann on Thursday said: “Last year, around this time, our office met with Medicaid and hospitals to discuss hospital payment initiatives, but we were told by Medicaid that these changes were not currently possible. The Legislature then turned to alternatives … We are always happy to discuss long-term solutions to stabilize hospitals in Mississippi and improve access to care.”

Gov. Tate Reeves announces his plans for a series of Medicaid reimbursement reforms during a press conference at the Walter Sillers Building in Jackson, Miss., on Thursday, September 21, 2023. Credit: Eric Shelton/Mississippi Today

Reeves presented his plan in a press conference flanked by several executives of the state’s largest hospitals. None of them spoke, and they were not made available for media questions in the briefing.

Gary Marchand is interim CEO of Greenwood Leflore Hospital, one of many small rural hospitals in Mississippi teetering on the brink of closure. Reeves, in his presser on Thursday, provided a sheet that showed Greenwood Leflore would receive an extra $10 million a year if his plan gets federal approval.

Marchand, contacted on Thursday, said he’s unsure how much of an impact the additional money would make, but he’s appreciative of “any efforts to provide additional cash resources in support of our operations.” He also added, “We are hopeful for a rapid approval process.”

Reeves on Thursday vowed his new plan is “just the beginning.”

“Our eyes are set on the future, and we aim to continue ushering in reforms that strengthen Mississippi’s healthcare system no matter where you live in the state,” Reeves said.

Mississippi Today reporter Devna Bose contributed to this story.

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

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Mississippi Today

Billionaire Tommy Duff forms Republican PAC as he weighs gubernatorial run

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3 hours ago

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January 7, 2025

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mississippitoday.org – Taylor Vance – 2025-01-07 11:40:00

Billionaire Tommy Duff, as he considers a run for Mississippi governor in 2027, has formed a political action committee to help elect Republicans to city and legislative offices this year, likely to increase his influence as a political powerbroker.

Jordan Russell, a longtime Republican operative who has led several federal and state campaigns, is director of the PAC, which was formed in December. 

Russell told Mississippi Today in a statement that Duff founded the PAC to support conservative candidates and advance policies that promote “opportunities, freedom, faith-based values and prosperity across Mississippi.” 

“We are planning a significant investment in multiple races in our state to ensure strong, conservative leadership at every level of government,” Russell said. 

Duff, a Hattiesburg resident and the co-wealthiest Mississippian along with his brother Jim, has been involved in state politics for decades, but mostly behind the scenes as a megadonor and philanthropist. He recently finished an eight-year stint on the state Institutions of Higher Learning Board, first appointed by former Gov. Phil Bryant. 

READ MORE: Will a Mississippi billionaire run for governor in the poorest state?

He’s travelled around the state in recent months meeting with political and business leaders, potentially laying the groundwork for a gubernatorial run. Duff also appeared at last year’s Neshoba County Fair and made the rounds at the state’s premiere political gathering. 

Duff and his brother turned a small, struggling company into Southern Tire Mart, the nation’s largest truck tire dealer and retread manufacturer. They created Duff Capitol Investors, the largest privately held business in Mississippi, with ownership in more than 20 companies, including KLLM Transport, TL Wallace Construction and Southern Insurance Group.

Duff has recently said he’s still weighing a run for governor, but his creation of a PAC that could garner support from many down-ticket Republicans would appear to be a concrete step in that direction. Duff’s entrance into a gubernatorial race would likely cause numerous potential candidates — particularly those who have looked to him for large campaign donations — to wave off.

While statewide elections are still two years away, municipal elections will take place this year and several special legislative races will happen as well. 

Rep. Charles Young, Jr., a Democrat from Meridian, died on December 19, and Rep. Andy Stepp, a Republican from Bruce, died on December 5. Sen. Jenifer Branning, a Republican from Philadelphia, was sworn into office yesterday for a seat on the Mississippi Supreme Court. Special elections will take place later this year to fill these vacancies. 

A federal three-judge panel also ruled last year that the Legislature  must create new state Senate and House maps with Black-majority districts and conduct special elections in 2025 under those newly created districts. 

The court ordered legislators to create a majority-Black Senate district in the DeSoto County area in north Mississippi and one in the Hattiesburg area in south Mississippi. The panel also ruled the state must create a majority-Black House district in the Chickasaw County area in northeast Mississippi. 

However, the Legislature will also have to tweak many districts in the state to accommodate for the new Black-majority maps. State officials in court filings have argued that the redrawing would affect a quarter of the state’s 174 legislative districts.

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

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Mississippi Today expands politics team for 2025 legislative session

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3 hours ago

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January 7, 2025

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mississippitoday.org – Adam Ganucheau – 2025-01-07 10:19:00

Mississippi Today is proud to announce the expansion of its politics team, dedicated to providing readers with in-depth reporting on the 2025 legislative session and key political issues shaping our state.

This team will rove the halls of the Mississippi Capitol in 2025, providing insightful daily updates, robust analysis, and in-depth coverage of state politics. The team will also produce investigations that aim to provide accountability to our state’s most powerful leaders.

Geoff Pender, a seasoned journalist with decades of experience covering Mississippi politics, continues his role as the politics team editor. Pender will guide the team as they tackle critical stories and offer insightful commentary on the decisions affecting Mississippians.

“We have a great team in place, a mix of old hands and fresh eyes, and one I believe will enhance Mississippi Today’s already unrivaled coverage of Mississippi government, politics and policies that impact us all,” Pender said.

Newcomers to the politics team — Simeon Gates and Michael Goldberg — join team veteran Taylor Vance to bring unique expertise to readers.

Simeon Gates, who has been with Mississippi Today since 2024, moves to the politics team to focus on education policy issues, highlighting how debates and decisions at the Capitol affect Mississippi’s schools, teachers and students. Gates is a Pearl native and alumna of University of Southern Mississippi.

Michael Goldberg joined Mississippi Today on Dec. 30, 2024, after more than two years with The Associated Press. Goldberg, who covered two Mississippi legislative sessions with the AP, will be posted at the Capitol daily. Goldberg is a California native and is an alumnus of Western Washington University and University of Southern California.

Taylor Vance, who has served on the Mississippi Today politics team since 2023, will continue to cover the Legislature and focus on elections and the political dynamics shaping the state’s future. Vance, a Grenada native, is an alumnus of the University of Mississippi.

PODCAST: Expanded Mississippi Today politics team talks 2025 legislative session

Mississippi Today Senior Political Reporter Bobby Harrison, who has been on the politics team since 2018, is transitioning to a new role in the newsroom that will be announced in coming days. Harrison will continue publishing his weekly political analysis in conjunction with newspaper partners across the state.

The politics team will continue producing its weekly podcast, “The Other Side,” and beginning this week, videos of episodes will be available to watch on our YouTube channel.

To follow Mississippi Today’s politics team and its coverage of the 2025 legislative session, you can do two things:

  1. Subscribe to our free weekly newsletter. There, the team will recap the previous week, forecast the upcoming week, and produce short videos and other written nuggets that you can’t find anywhere else.
  2. Bookmark our 2025 Legislative Guide, which includes resources you need to engage with lawmakers and follow their action this year. This page will also update whenever a new legislative story from Mississippi Today publishes.

Thank you for reading, and don’t hesitate to email us if you have any questions or tips.

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

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OptumRx sues Mississippi Board of Pharmacy, alleges due process violation

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5 hours ago

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January 7, 2025

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mississippitoday.org – Gwen Dilworth – 2025-01-07 08:49:00

A lawsuit filed by a major pharmacy benefit manager in December alleges the Mississippi Board of Pharmacy violated the company’s right to due process by releasing the findings of an audit before determining any wrongdoing. 

The audit’s findings, released by the Board of Pharmacy in October, indicate that OptumRx may have violated Mississippi law by paying independent pharmacies in Mississippi rates lower than chains and Optum-affiliated pharmacies for the same prescription drugs in 2022. 

Mississippi law prohibits pharmacy benefit managers from reimbursing their affiliate pharmacies, or those they own, at higher rates than non-affiliate pharmacies for the same services.

OptumRx filed the complaint in Hinds County Chancery Court on Dec. 10, naming all seven Board of Pharmacy members and Executive Director Susan McCoy as defendants. The lawsuit asks the judge to rule that an independent hearing officer preside over the administrative hearing on the audit’s findings.

Administrative hearings can lead to disciplinary action by the Board of Pharmacy, including fines. 

A “one-sided press release” issued by the Board of Pharmacy – a two-page document summarizing the 848-page audit completed by Ridgeland-based HORNE accounting firm – thwarted OptumRx’s right to a fair and impartial hearing and demonstrated the board’s bias against the company, said the lawsuit. 

The press release did not note the company’s upcoming administrative hearing to determine whether it had violated Mississippi law or state that OptumRx disputes the board’s claims. 

An administrative hearing on the alleged law violations was previously scheduled for Dec. 19 but has been delayed due to the lawsuit.  

The board declined to provide an independent hearing officer to oversee the administrative proceedings or to remove the press release from their website. It said it would “entertain” the possibility of posting a rebuttal from OptumRx, according to the lawsuit. 

OptumRx declined to comment on the lawsuit, but a spokesperson for the company previously told Mississippi Today that it has identified errors in the audit’s findings and methodology and submitted them to the Board of Pharmacy. 

The Board of Pharmacy declined to comment on ongoing litigation or administrative hearing matters, and HORNE did not respond to Mississippi Today by the time this story published. 

OptumRx argued that the audit’s methodology was unfair because it did not investigate the services provided by affiliated, chain and independent pharmacies and instead assumed that all pharmacies dispensing the same prescription drugs offer identical services. 

“It is wholly inappropriate to assume parity of service offerings between different types of pharmacies, such as OptumRx’s affiliated (long-term care) pharmacy and retail pharmacy,” wrote the lawsuit.

The audit’s analysis of a generic drug used to treat bacterial infections alleged that an Optum-affiliated pharmacy was paid eight times more than the lowest-paid independent pharmacy on the same day. Chain and affiliate pharmacies were allegedly paid over 20 times as much as independent pharmacies for a generic drug used to treat stomach and esophagus problems.

The audit’s findings have already led to litigation against the company.

In November, Valley Drugs, Inc., a Water Valley pharmacy, filed a class action federal lawsuit against OptumRx and its parent company, UnitedHealth Group, seeking damages for alleged violations of Mississippi’s prescription drug reimbursement regulation and citing the audit’s findings. 

OptumRx is owned by health care behemoth UnitedHealth Group Inc., the U.S.’ most profitable health care company and the owner of the nation’s largest health insurance company, UnitedHealthcare. In 2023, the company brought in $32.4 billion in earnings. 

OptumRx is the third-largest pharmacy benefit manager in the nation, representing 22% of the industry’s market share in 2023.

A Federal Trade Commission report in July found that in general, large pharmacy benefit managers pay their own, affiliated pharmacies significantly more than other pharmacies and set reimbursement rates at untenably low levels for independent drug stores.

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

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