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
Warm Thursday ahead of unsettled weekend – Home – WCBI TV
SUMMARY: Temperatures in Columbus, Mississippi will remain in the upper 80s on Thursday with a chance of rain. Expect filtered sun and possible showers or storms in the evening. Overnight, isolated showers are possible with lows in the middle 60s. Friday may see periods of steady to heavy rain with uncertain timing. The weekend will feature isolated rain on Saturday and scattered showers and storms on Sunday. Next week, there will be a focus on increasing heat and humidity with the potential for the first 90-degree day on Wednesday and growing storm potential later in the week.
The post Warm Thursday ahead of unsettled weekend – Home – WCBI TV appeared first on www.wcbi.com
Mississippi News
Mississippi State baseball tops Ole Miss to win Governor’s Cup
SUMMARY: Mississippi State baseball defeated Ole Miss in the Governor's Cup with a 5-1 win, splitting the season series. Pico Kohn had a strong start for the Bulldogs, and Judd Utermark and Hunter Hines contributed offensively. Mississippi State scored four runs in the eighth inning to secure the win. Tyson Hardin closed the game in the ninth. The Bulldogs will face Alabama next, while Ole Miss will play against Auburn. Mississippi State secured their second straight Governor's Cup win and showcased a strong performance both on the mound and at the plate.
The post Mississippi State baseball tops Ole Miss to win Governor's Cup appeared first on www.wcbi.com
Mississippi News
High grocery costs have many seeking alternative options
SUMMARY: Families are turning to local farms like Native Son Farm to source produce, combating rising grocery prices. Native Son Farm provides local, certified naturally grown, chemical-free produce through community-supported agriculture programs. Eating organic, locally grown produce is budget-friendly compared to commercial stores. Cooking healthy meals doesn't have to sacrifice taste, as shown by certified nutrition coach Julie Gibens. She encourages people to check ingredients in foods they buy and offers classes on making healthy choices. Large quantities of food are cooked in bulk and frozen in small portions for convenience. Overall, the trend towards farm-to-table and healthy eating is growing.
The post High grocery costs have many seeking alternative options appeared first on www.wcbi.com
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