What now? Three groups of people are exempt from UMMC’s out of-network policy. They will also not be eligible for in-network benefits. Blue Cross & Blue Shield of Mississippi informed its customers that it will continue to offer network benefits to UMMC patients. This means that BCBS will still pay the in-network rate. However, this won’t stop UMMC patients paying high-priced out-of-pocket expenses for non-emergency services. Blue Cross instructed its customers to give written instructions to UMMC to make benefit payments. UMMC would not accept payment from BCBS if this happened. This is because a 2013 Mississippi law prohibited balance billing. UMMC insists that they won’t accept payment from BCBS. “If we did that (accept the payment form BCBS), then they could pay us whatever they want in perpetuity and we wouldn’t have any control over it,” Dr. Alan Jones of UMMC, associate vice chancellor, clinical affairs, stated to Mississippi Today in March. Blue Cross & Blue Shield of Mississippi thinks the hospital must accept payment from BCBS or treat the services as fully paid – an interpretation that Mike Chaney, Mississippi Insurance Commissioner, and UMMC disagree with. Blue Cross & Blue Shield of Mississippi members may direct us that UMMC pay directly for the services it rendered. Blue Cross & Blue Shield of Mississippi (BCBSMS) is required to honor the direction of payment, and UMMC is required to accept BCBSMS’ payment as payment in full for covered services and even if UMMC rejects BCBSMS’ payment, the statute provides ‘that payment shall be considered payment in full to the provider, who may not bill or collect from the insured any amount above that payment [other than deductible and coinsurance/copay]….,” Cayla Mangrum, manager of corporate communications for the company, said in a statement to Mississippi Today last week. She stated that UMMC’s stated intent to refuse payment from Blue Cross & Blue Shield of Mississippi to which a Member has directed is not in accordance with the consumer protection statute. This would be a deprivement of a right our Members are entitled to under Mississippi law. Chaney weighed in with this interpretation: “There is nothing in the code section that requires UMMC accept payment from BCBS.” Marc Rolph was the executive director of communications marketing at the hospital. Rolph stated that UMMC doesn’t believe an insurance company can unilaterally dictate the business practices for a healthcare provider. Rolph stated that patients will have to file claims directly with BCBS, and then pay the UMMC bill. Patients will get a reimbursement directly from BCBS, which will be lower than the UMMC bill. UMMC stated that it would offer BCBS patients a discount on the care they receive. However, even with this discount their care will still be significantly more expensive than if BCBS were still in-network.