/Health coverage for thousands of Mississippians in question as UMMC and Blue Cross negotiate contract

Health coverage for thousands of Mississippians in question as UMMC and Blue Cross negotiate contract

Although the contract dispute dates back in 2018, it was resolved temporarily when an agreement was reached between the entities. Blue Cross, the largest state-owned insurer, is requesting that UMMC pay higher reimbursement rates for services rendered. BCBS refused to comply with this request. Contracts between providers and insurers include huge discounts for providers within their networks. If no agreement is reached by March 31, UMMC will be forced from the BCBS network. This would mean that thousands of BCBS-insured patients will have to either pay the “chargemaster” prices for the hospital or seek out other health care. UMMC officials have sent a notice to all its patients who have BCBS commercial plans this week to inform them of how the outcome of the negotiations could affect their coverage. In a statement to Mississippi Today, Dr. LouAnn Woodward, UMMC vice-chancellor for health affairs, stated that “our negotiations with Blue Cross continue” and she was hopeful that a new contract could be reached before the current agreement expires. Blue Cross & Blue Shield of Mississippi representatives did not respond on Friday to a request for comment. Even if no new agreement is reached, Mississippi State and School Employees Health Insurance Plan members would not be affected. The current negotiations do not affect commercial insurance plans. Nevertheless, the BCBS is the largest private insurance provider in Mississippi. This would mean that thousands of Mississippians could be affected. These patients would need to switch providers or pay more. Many would not have the option of choosing if they needed specialized services that were only provided by the hospital. These services include Mississippi’s only Level 1 Trauma Center, Level IV Neonatal ICU Unit, and Children’s Hospital, as well as other critical care services. It is not the first time that UMMC has fought with BCBS over contract negotiations. UMMC sought higher reimbursement rates prior to their 28-year-old contract expiring on June 30, 2018, with BCBS. The negotiation process dragged on for several months and was overdue when the BCBS contract expired. However, patients with BCBS plans were still considered to be in-network during negotiations. In August 2018, a new contract was finally signed. This contract is the core of the current dispute.