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Blue Cross sues top UMMC officials

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Blue Cross sues top UMMC officials over PR campaign

Blue Cross & Blue Shield of Mississippi is suing several top employees, alleging defamation and civil conspiracy over the public relations campaign the hospital has been waging against the insurer due to their contract dispute. 

Blue Cross filed a in Rankin County's circuit court on Thursday against UMMC employees LouAnn Woodward, Vice Chancellor for Affairs and Dean of the School of Medicine, Alan Jones, Associate Vice Chancellor for Clinical Affairs, Marc Rolph, Executive Director of Communications and Marketing, and other unnamed UMMC employees.

Rolph declined to comment on the lawsuit.

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UMMC itself is not named as a defendant in the lawsuit because UMMC immunity for defamation committed by its employees. 

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. Since then, UMMC has spent nearly $279,000 on digital ads, commercials and billboards attacking the insurer.

In the lawsuit, Blue Cross alleges that the public relations campaign was “designed to disseminate false and defamatory statements about Blue Cross to the public.”

Blue Cross' major issue with the campaign's advertisements and various public statements the defendant's have made is that they allege Blue Cross ended its contract with UMMC and the insurer has “excluded” UMMC from its network of providers as a result. Since UMMC voluntarily ended its contracts with Blue Cross, the insurer claims UMMC's campaign is defamatory and has harmed its reputation and business.

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Blue Cross has continued to offer network level reimbursement rates for its customers that seek care at UMMC, but the hospital has refused to accept those payments. Due to this refusal and UMMC being the party that ended their relationship, Blue Cross says it is UMMC who is preventing the insurer's customers from receiving care at the medical center. 

The insurer also claims in the lawsuit that other public comments UMMC officials have made related to the contract dispute are false. One such claim is that Blue Cross has not increased its reimbursement rates to UMMC since 2018. While UMMC claims the only increase it has received in recent years is a 1% increase in 2018, Blue Cross claims it has increased reimbursement rates every year since then. Since all financial agreements between the two parties are confidential, is unable to verify the claims of either party on this issue.

Another claim Blue Cross says is false is that UMMC was not responsible for removing transplant patients insured by Blue Cross from their transplant lists. 

According to Blue Cross, a transplant patient was scheduled to have their surgery during this grace period, but the hospital canceled the procedure. In another instance, the of a pediatric transplant patient were advised to seek their child's care out-of-state. Both patients eventually received that surgery “only after Blue Cross vigorously challenged UMMC's actions.” The insurer claims that other instances like these have occurred.

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Mississippi Today has previously reported on transplant patients who have been forced to seek their care out-of-state. Others have been unable to get estimates of how much their surgeries would cost from UMMC or Blue Cross as required by federal law.

Blue Cross is seeking an injunction against the continued publication and dissemination of the statements it considers defamatory as well as monetary damages from each of the defendants. 

Read the full complaint here:

Editor's note: UMMC, through an ad agency, has placed paid advertisements about the BCBS dispute on Mississippi Today's website. Advertisers have no input in the editorial .

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

Mississippi News

Mississippi State baseball tops Ole Miss to win Governor’s Cup

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www.wcbi.com – Kam Dyer – 2024-05-01 22:15:16

SUMMARY: Mississippi defeated in the Governor's Cup with a 5-1 win, splitting the season . 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 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.

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Mississippi News

High grocery costs have many seeking alternative options

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www.wcbi.com – Allie Martin – 2024-05-01 19:18:06

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- produce through community-supported agriculture programs. Eating organic, locally grown produce is budget-friendly to commercial stores. Cooking healthy meals doesn't have to sacrifice , 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.

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Mississippi News

MDOT construction: Traffic hits brakes on Highway 82

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www.wcbi.com – Shawanda Jones – 2024-05-01 19:05:20

SUMMARY: Construction on Highway 82 in Columbus, Mississippi has raised questions about why the work is not being done at night. The main reason for daytime work is safety concerns for both workers and drivers, as well as the higher cost of nighttime construction. Drivers are advised to merge early and exercise patience, as traffic congestion and lane closures can cause delays. Matt Dunn, Engineer, reassures drivers that the will result in a smoother ride once completed. The project is expected to finish by the end of summer. Drivers can stay updated on road closures and alerts through the MDOT app and social .

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