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Mike Chaney writes letter on behalf of man in need of liver transplant

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Insurance commissioner asks UMMC and Blue Cross to help man featured in Mississippi Today stories

Mississippi Insurance Commissioner Mike Chaney sent a letter late Friday to attorneys for and of Mississippi Medical Center on behalf of Frank Dungan, the resident in need of a liver transplant who was in recent Mississippi Today stories.

Dungan, a liver transplant candidate at UMMC with Blue Cross insurance, is currently ineligible for a transplant because of the hospital’s out-of-network status with the insurance company. UMMC went out of network on April 1 after it and Blue Cross failed to resolve a contract dispute

Blue Cross is steering Dungan toward out-of-state transplant centers in Memphis or Birmingham, but Dungan wants to stay with UMMC, where he’s developed relationships with who know his history. 

READ MORE: โ€˜I’m scared I’m going to freaking die’: Mississippi man can’t get answers to life-and-death questions from Blue Cross, UMMC

Over the past month, Dungan attempted to get cost estimates from both UMMC and Blue Cross of what each party will charge and pay if he received his transplant at the hospital while it was still out of network with the insurer. He couldn’t get answers from either, so he started making calls to everyone he could think of โ€” including officials at the Mississippi Insurance Department. 

Chaney told UMMC and Blue Cross he thinks Dungan’s request is โ€œvery reasonable.โ€

โ€œHe simply asks that UMMC provide a good faith estimate of what his liver transplant will cost, including an estimate of what he may be looking at in terms of increased charges due to balance billing for services which may be rendered beyond June 30,โ€ Chaney wrote in the May 13 letter. โ€œFurther, he requests that BCBSMS take the estimated charges furnished by UMMC and provide a good faith estimate of the โ€˜in-network rate’ reimbursement that would be provided by BCBSMS โ€ฆ He needs this information in order to determine whether he has sufficient savings and personal assets to cover any excess charges that may apply.โ€

Chaney also asked that the two parties work together to ensure he can receive a transplant without becoming financially destitute or traveling long distances for care. 

โ€œPlease work together to enter a single case agreement that will shield Mr. Dungan from any excess charges above and beyond his standard cost-sharing responsibilities,โ€ wrote Chaney. โ€œThis single case approach will allow Mr. Dungan to receive the life-saving transplant he so desperately needs without depleting his life savings and without him having to travel long distances to have the procedure done in a location where he has no family or other support group who could assist him in the recovery and healing process.โ€

He asked both Blue Cross and UMMC to respond to Dungan and the insurance department by Tuesday, May 17 at 10 a.m.

Dungan said a representative from UMMC called him over the weekend to provide a cost estimate for the transplant surgery if he paid completely out of pocket. The hospital is going back to create an updated estimate for the cost if insurance is involved โ€“ meaning Dungan would direct Blue Cross to pay its โ€œnetwork benefitโ€ amount directly to him to then pay UMMC. Dungan would then be responsible for the balance between what UMMC charged and Blue Cross paid.

Chaney made another pointed statement at the end of the letter: He asked the lawyers to review state that requires health insurance companies maintain a network of doctors that is โ€œsufficient and numbers and types of participating providers to covered persons will be accessible without unreasonable delay.โ€

This is not the first time Chaney has raised concerns over whether Blue Cross is meeting network adequacy requirements with UMMC out of network. 

Chaney referred to the โ€œunique servicesโ€ only available at UMMC in a March 3 letter to Carol Pigott, Blue Cross’ president and chief executive officer. He cited the ‘s hospital, organ and tissue transplant program and Level IV neonatal intensive care unit, among other programs. 

โ€œWithout the adequate availability of these specialized services in the BCBSMS Network, I believe there would be a disruption of needed services to consumers in Mississippi, thus potentially creating a Network Adequacy issue for BCBSMS,โ€ the letter, which was also sent to the governor, lieutenant governor and speaker of the House of Representatives, stated. 

Chaney directed Blue Cross to produce a โ€œNetwork Adequacy Status Reportโ€ showing how Blue Cross will meet its statutory requirements if UMMC goes out of network. 

Cayla Mangrum, of corporate communications, said the report was โ€œconfidential and proprietaryโ€ when Mississippi Today asked for a copy of Blue Cross’ response. 

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

Mississippi News

Vicksburg man charged with assaulting woman in domestic dispute

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www.wjtv.com – Kaitlin Howell – 2024-11-02 11:33:00

SUMMARY: In Vicksburg, Mississippi, a domestic assault led to the hospitalization of a man and woman on November 2. were alerted by Merit Region after a 28-year-old man, Daron Evans, arrived with a stab wound. Authorities dispatched to the scene found the woman, who had also been assaulted. After receiving treatment, Evans was and charged with aggravated assault domestic violence; he is held without bond until his court appearance. The woman is in stable at the . An investigation is ongoing.

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Mississippi News

Cloudy and humid weekend – Home – WCBI TV

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www.wcbi.com – Sadie Morris – 2024-11-02 10:13:00

SUMMARY: In Columbus, Mississippi, humid and cloudy weather is expected, with temperatures remaining above average in the lower 80s for the upcoming . Rain is forecasted for Election Day on Tuesday, continuing into the week with isolated showers likely. This Saturday will see patchy fog in the morning, clearing by midday, with a high around 80 degrees. Sunday will bring similar humidity, with a high in the lower 80s and mild overnight lows in the mid-60s. Throughout the week, expect persistent clouds and humidity alongside mild temperatures.

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Mississippi News

Sports Zone Saturday: A must-win weekend for Mississippi's college football teams

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www.wjtv.com – Blake Levine – 2024-11-02 09:43:00

SUMMARY: College football is back in Mississippi for the 2024 season, with a lineup of exciting this Saturday. The Zone team will special coverage from 10:00 to 11:00 a.m. on . Notable matchups include No. 19 visiting Arkansas at 11:00 a.m. CT on ESPN, while Mississippi State celebrates Homecoming against UMass at 3:15 p.m. CT on the SEC Network. State UAPB for their Homecoming at 2:00 p.m. CT on ESPN+, and Alcorn State travels to face Alabama State at 4:00 p.m. CT on ESPN+. Southern Miss has a bye .

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