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Insurance chief says UMMC violating state law

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Insurance chief Mike Chaney says UMMC is violating state law in BCBS dispute

Insurance Commissioner Mike Chaney says he believes that the University of Mississippi Medical Center (UMMC) is violating state law by turning patients away from the state’s only safety net hospital. 

The state insurance department, according to Chaney, has received numerous complaints from UMMC patients who have been told by their doctors that they cannot receive care at the hospital because they are insured by Blue Cross & Blue Shield of Mississippi.

UMMC has been out of network with Blue Cross, the state’s largest insurer, since April 1 due to disagreements over reimbursement rates and Blue Cross’ quality care plan.

Chaney said that he believes UMMC turning away patients would violate Mississippi Code 37-115-31, which states that UMMC “shall be utilized to serve the people of Mississippi generally.”

“If you are the university hospital, you have a moral and ethical obligation to take care of Mississippians and a statutory requirement that you do so,” Chaney said.

Chaney said that his office has forwarded several of these allegations to UMMC and “other proper authorities that can enforce the law.”

Under federal law, public hospitals like UMMC may not deny a patient care based on the ability to pay or who the insurance provider is. UMMC and Blue Cross are still honoring in-network rates for Blue Cross patients who come into UMMC’s emergency room. Mississippi Today has not independently confirmed any instance of UMMC turning away a patient in an emergency situation. 

UMMC’s official policy is that each Blue Cross customer must sign a form that confirms the patient is aware that UMMC will not accept payment from Blue Cross for any elective services and that they will be responsible for their medical bills if they continue their care at the hospital. With Chaney’s allegations, it is unclear if this policy is being followed with each Blue Cross patient. 

“The problem is the people at the top that we deal with (at UMMC) are telling us one thing when what’s happening down at the bottom is totally different from what they’re telling us,” Chaney said. 

UMMC spokesperson Marc Rolph said the hospital had “no comment” on Chaney’s allegation that UMMC is violating state law. 

Federal law required UMMC to continue honoring in-network rates for certain patients for a 90-day period after it went out of network, but that “continuity of care” grace period expired on July 1. Since then, children with rare genetic conditions and transplant patients have been forced to seek their care out of state or switch to another insurer

Chaney has also previously alleged that without UMMC in its network, Blue Cross is violating network adequacy requirements. There are a litany of specialty services UMMC provides, such as its children’s cancer care program and transplant programs, that can’t be found anywhere else in the state. State law requires that Blue Cross customers have reasonable access to these services if the services are covered by their insurance plan.

Chaney launched a network adequacy review of Blue Cross on July 1, the results of which likely won’t be finalized or made publicly available for months. 

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

Mississippi News

Monroe county sheriff’s department investigating church fire

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www.wcbi.com – Khamari Haymer – 2024-11-13 19:02:00

SUMMARY: Harmony Baptist Church in Monroe County, Mississippi, was destroyed by fire last Friday night, leaving caretaker Mary Nell Dorris in shock. She received a panicked call from a neighbor while asleep and rushed to the scene, where she stayed until the early morning. The historic church, built in the mid 1800s and lacking gas or electric power, is suspected to have been intentionally set ablaze. While no injuries were reported, Dorris mourns the loss of cherished memories associated with the church. The Monroe County Sheriff’s Department is investigating and urges anyone with information to come forward.

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Mississippi News

Tupelo Police investigate ATM ‘Jackpotting’ heist

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www.wcbi.com – Allie Martin – 2024-11-13 18:58:00

SUMMARY: Tupelo Police Chief John Quaka reported progress in an ATM jackpotting investigation after a bank employee discovered forced entry at the Community Bank Branch on November 13. The machine was found partially open, leading to a significant cash theft. Surveillance footage captured two suspects in a silver Honda Accord, believed to be connected to similar crimes statewide. Jackpotting involves inserting malware into ATMs to dispense cash. The FBI has been notified, and police are collaborating with state agencies. Chief Quaka expressed confidence in making arrests and urged banks to keep their systems updated and secure.

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Mississippi News

Bond set for three accused of assaulting woman in Vicksburg

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www.wjtv.com – Kaitlin Howell – 2024-11-13 16:44:00

SUMMARY: Three suspects were arrested in Vicksburg, Mississippi, after a violent assault was streamed live on Facebook on November 9. Ronjanae Hill (24), Marcus Ross (33), and Charles Doss (27), all from Vicksburg, were charged with aggravated assault. They appeared in Vicksburg Municipal Court on November 12. Hill and Ross each received a $75,000 bond, while Doss’s bond was set at $100,000. All three were bound over to the Warren County Grand Jury. The assault occurred at an apartment complex, and further details about the incident were not disclosed.

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