Nearly four months in, still no developments in mediation between UMMC and Blue Cross

by Will Stribling, Mississippi Today
September 20, 2022

The contract dispute between the state's largest insurer and hospital is still not resolved more than three months after the two parties began mediation proceedings.

Blue Cross & Blue Shield of Mississippi and University of Mississippi Medical Center have been locked in a dispute over reimbursement rates throughout 2022. The Medical Center went out of network with Blue Cross on March 31, and since then, thousands of Mississippians have been forced to take on higher out-of-pocket costs for their health care or leave the state for certain specialty care.

The two parties agreed to utilize a mediation process to settle the dispute in April after Insurance Commissioner Mike Chaney urged them to do so. 

“The commissioner (Mike Chaney) is certainly very hopeful that the parties can make great progress, if not find a resolution, by early June,” Mark Haire, deputy commissioner of insurance, told Mississippi Today in early May.

Evidently, that hope was misplaced.

Patrice Guilfoyle, director of communications at UMMC, told Mississippi Today on Tuesday that there's “no update at this point” on mediation proceedings. Blue Cross did not respond to requests for comment by the time of publication. 

Chaney told Mississippi Today he has not had any contact with either party or the mediator relating to mediation since before Sept. 5. Under state agency rules, Chaney is not allowed to directly mediate or help settle disputes over contacts between insurance companies and health care providers. 

There is no requirement the two parties come to an agreement.

A targeted market conduct examination of Blue Cross that Chaney ordered on July 1 is ongoing. The examination is to determine whether the insurer is in compliance with the state's network adequacy regulations since UMMC provides specialty care that cannot be found elsewhere in Mississippi.

Chaney told Mississippi Today on Tuesday that the network adequacy review is nearly complete but cannot be finished until UMMC provides his office with materials that have been subpoenaed.

“It (the network adequacy review) will probably be surprising to a lot of folks,” Chaney said.

Blue Cross sued top UMMC employees on July 28 over the public relations campaign the hospital has been waging against the insurer due to their contract dispute. The insurer claims the campaign was “designed to disseminate false and defamatory statements about Blue Cross to the public.”

In advertisements and public statements made by employees, the claim was made that the insurer “excluded” UMMC from its network of providers, though it was UMMC who voluntarily allowed its contract with Blue Cross to expire. 

It is unclear how that lawsuit has impacted the progress of mediation proceedings. 

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