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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 Blue Cross & Blue Shield of Mississippi and University of Mississippi Medical Center on behalf of Frank Dungan, the Madison resident in need of a liver transplant who was featured 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 doctors who know his history. 

READ MORE: ‘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 — including officials at the Mississippi Insurance Department. 

Chaney told UMMC and Blue Cross he thinks Dungan’s request is “very reasonable.”

“He 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,” Chaney wrote in the May 13 letter. “Further, he requests that BCBSMS take the estimated charges furnished by UMMC and provide a good faith estimate of the ‘in-network rate’ reimbursement that would be provided by BCBSMS … He needs this information in order to determine whether he has sufficient savings and personal assets to cover any excess charges that may apply.”

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. 

“Please 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,” wrote Chaney. “This 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.”

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 – meaning Dungan would direct Blue Cross to pay its “network benefit” 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 law that requires health insurance companies maintain a network of doctors that is “sufficient and numbers and types of participating providers to covered persons will be accessible without unreasonable delay.”

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 “unique services” only available at UMMC in a March 3 letter to Carol Pigott, Blue Cross’ president and chief executive officer. He cited the children’s hospital, organ and tissue transplant program and Level IV neonatal intensive care unit, among other programs. 

“Without the adequate availability of these specialized services in the BCBSMS Network, I believe there would be a disruption of needed health care services to consumers in Mississippi, thus potentially creating a Network Adequacy issue for BCBSMS,” 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 “Network Adequacy Status Report” showing how Blue Cross will meet its statutory requirements if UMMC goes out of network. 

Cayla Mangrum, manager of corporate communications, said the report was “confidential and proprietary” 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

Events happening this weekend in Mississippi: November 22-24

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www.wjtv.com – Kaitlin Howell – 2024-11-22 08:50:00

SUMMARY: This weekend (November 22-24), Mississippi offers a variety of events for everyone. Highlights include the Fleet Feet Coffee Run in Ridgeland, the Miss Magnolia State Pageant in Vicksburg, and the Handworks Holiday Market in Jackson. In Jackson, enjoy exhibits like “Dinosaurs Around the World” and “Of Salt and Spirit,” plus festive activities such as the “Magic of Lights” display and the “Journey to the North Pole” exhibit. In Hattiesburg, check out the Faculty Artist Series, the Pine Belt Holiday Expo, and the Ford Foundation Turkey Trot. Other events include markets, festivals, and live music throughout the state.

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Mississippi News

Attorneys file motion to delay Jackson bribery trial

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www.wjtv.com – Kaitlin Howell – 2024-11-21 16:41:00

SUMMARY: In connection with the Jackson bribery scandal, attorneys for federal officials and local leaders filed a motion to postpone the trial to allow time for extensive evidence review, including hours of recordings and thousands of pages of documents. Key figures charged include Hinds County DA Jody Owens, Jackson Mayor Chokwe A. Lumumba, and Councilman Aaron Banks, each facing multiple counts of conspiracy related to bribery and fraud. The scandal involves alleged bribes amounting to over $80,000 related to a downtown development project, facilitated by individuals posing as real estate developers working with the FBI.

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Mississippi News

Family of Dexter Wade rallies outside JPD nearly two years after his death

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www.wjtv.com – Tia McKenzie – 2024-11-20 14:20:00

SUMMARY: Nearly two years after Dexter Wade’s death, his family continues seeking justice. On November 20, Dexter Wade Day was observed in Jackson, declared by Councilman Kenneth Stokes. Wade, hit by a Jackson police cruiser in March 2023, was later found in a pauper’s grave in Hinds County, and his mother, Bettersten Wade, was unaware of his death until August 2023. She believes his death was covered up. No arrests have been made, and authorities consider it an accident. Jackson Police Chief Joseph Wade expressed condolences and shared updates on new policies to prevent similar tragedies.

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