Time Runs Out On Blue Cross, UMMC Grace Period

A stalled mediation process has left all non-emergency patients with Blue Cross Blue Shield Mississippi health insurance out of network at the University of Mississippi Medical Center. Photo courtesy UMMC Communications

All non-emergency patients with Blue Cross Blue Shield of Mississippi health insurance are now considered out of network at the University of Mississippi Medical Center and its many clinics around the state.

Ninety days have elapsed since the end of Blue Cross’ contract with the UMMC, and negotiations have stalled, leaving many insured Mississippians without affordable access to care at the state’s largest medical complex. The three-month stand-off period marks the end of the grace period for patients already undergoing treatment at UMMC with Blue Cross insurance.

Mississippi’s Insurance Commissioner Mike Chaney joined the negotiations shortly after the collapse of the contract in late March, but his intercession to recommend a mediation process like the one that led the parties to an agreement in 2018 does not appear to have solved the break.

“It was my hope when I offered mediation several months ago that an agreement would be reached by close of business on June 30, 2022,” Chaney wrote in a June 30 statement. “Sadly that is not the case. However, mediation is ongoing, and I remain optimistic that both parties can reach an agreement and not leave tens of thousands of consumers hanging in the balance.”

As the grace period expired, the Mississippi State Medical Association spoke up in favor of UMMC, castigating the insurance giant’s Mississippi branch for “corporate greed.”

The Mississippi State Medical Association (MSMA) has long fought for physicians and most importantly, the patients in our great state. However, Blue Cross Blue Shield of Mississippi’s corporate greed on multiple issues, including prior authorizations, access to care, reimbursement cuts, and telemedicine has made that fight increasingly difficult,” the statement read in part.

Dr. Alan Jones, UMMC associate vice chancellor for clinical affairs and professor of emergency medicine, told the Mississippi Free Press in March that UMMC was an academic and medical anchor for the state, and thus required a different reimbursement rate than other hospitals in Mississippi. “Just like the other academic medical centers in our region, (we) demand a different reimbursement rate than other hospitals,” Jones said.

Blue Cross, Jones continued, had disagreed. “What they’ve said to us is ‘we have an adequate network without UMMC in it.’ … By virtue of not negotiating with us, that signals that they don’t believe they need us in their network.”

Previously, Blue Cross’ Corporate Communications Manager Cayla Mangrum told the Mississippi Free Press that UMMC’s demands overvalue its place in the health-care ecosystem of the region. “As to UMMC’s claim to be paid more as an academic medical center, UMMC is comparing themselves to institutions they are not,” Mangrum wrote. “For example, UMMC’s publicly reported quality scores are lower than other nearby academic medical centers where our Members frequently seek services.”

In the July 1 statement, MSMA accused Blue Cross of compromising the lives of Mississippi patients for financial gain. “Ultimately, Blue Cross has no other concern than to increase its bottom line,”  it wrote. “And that bottom line is increasing at the cost of its insureds’ health, safety, and well-being.”

Today, Mangrum declined a request for further comment. UMMC’s Executive Director of Communications and Marketing Marc Rolph also declined a request for comment.

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