Insurance Commissioner suspends mediation between UMMC and Blue Cross

Insurance Commissioner suspends mediation between UMMC and Blue Cross

Insurance Commissioner Mike Chaney last week suspended mediation between the University of Mississippi Medical Center, the state’s largest hospital, and Blue Cross and Blue Shield of Mississippi, its largest private insurer.

Chaney said Thursday he made the decision to suspend him indefinitely because “no progress has been reported to my office in the last six weeks.”

A few hours later, however, Chaney sent an updated statement to Mississippi Today saying that although he suspended mediation, “both parties are continuing talks to resolve the network dispute and I believe an agreement early settlement is possible”.

If no settlement is reached in the “near future,” the dispute will be the problem for lawmakers and higher education institutions to resolve, he said.

UMMC terminated its contract with Blue Cross earlier this year and officially left the network with the insurer on April 1. This decision has had a significant impact on Mississippians with Blue Cross, especially those who use services only available at UMMC, including transplant candidates and children in need of specialty care.

“It is deplorable that the citizens of our state are being used as pawns to settle this dispute,” Chaney said, echoing comments he made to the House and Senate Insurance Committees in a joint meeting. the 3rd of October.

Patrice Guilfoyle, director of communications at UMMC, provided a statement via email.

“UMMC remains engaged in the mediation process with the goal of resolving the dispute as quickly as possible,” the statement said.

Blue Cross did not respond to a request for comment on this story. Insurer employees have not responded to questions or interview requests from Mississippi Today for several months.

It’s unclear whether the suspension is the result of the two parties’ impasse or because they haven’t contacted Chaney’s office in more than a month.

Addressing lawmakers, Chaney also referenced complaints his office has received from consumers, which he called “horrible.” Emails to the department show a parent of two children with cancer and kidney disease describing how the family faces “significant expense” to continue receiving care at UMMC.

“Going out of state for care requires time off from work and time missed from school. It also means building new relationships with doctors and other medical personnel,” wrote the relative, whose name and other identifying information has been redacted.

Chaney also told lawmakers he would push legislation in 2023 to prevent insurance companies and hospitals from terminating contracts more than 90 days before open federal listing.

“I will pursue legislation in the 2023 legislative session to prevent consumers in the future from being caught in the middle of these types of contract disputes,” Chaney wrote in the Oct. 7 letter to UMMC leadership. and Blue Cross announcing its decision to suspend mediation. “I told a Joint Legislative Committee at a hearing… that the MID had not been informed since the end of August of any progress in the mediation process and that we were going to pursue the legislation. I now see both sides opposing any consumer protection legislation and lobbying lawmakers.

In April, Chaney urged the two sides to seek an expert, impartial mediator who could preside over negotiations, which focus on reimbursement rates and the insurance company’s quality care program. The two sides agreed to a mediator – Walter Johnson of the Jackson Watkins & Eager law firm – in May. Mediation officially began in June.

The two sides used the same process in their last contract dispute in 2018, and it took about 10 days to reach an agreement.

Under state agency rules, Chaney is not allowed to arbitrate directly or help settle disputes.

Editor’s Note: Kate Royals, Mississippi Today’s Community Health Editor since January 2022, worked as a Writer/Editor for the UMMC Communications Office from November 2018 through August 2020, writing press releases and reports on the medical center’s dental and nursing schools. A longtime reporter at major newsrooms in Mississippi, Royals had been a Mississippi Today reporter for two years prior to his move to UMMC. At UMMC, Royals was in no way involved in management decisions or anything related to the medical center’s relationship or contract with Blue Cross and Blue Shield of Mississippi.







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