Mississippi Lawmakers Might Intervene in Blue Cross, HMA Dispute

Mississippi lawmakers said at a recent legislative hearing that they might intervene in the dispute between Blue Cross & Blue Shield of Mississippi and 10 state hospitals owned by Naples, Fla.-based Health Management Associates if the health insurer and hospital operator can't resolve the conflict on their own, according to a report from The Clarion-Ledger.

The legislative hearing followed months of disagreement about the contract between BCBS and the Health Management hospitals. The hospitals all sued the insurer in June, claiming the payer has been underpaying them by millions for certain inpatient procedures.

In July, the insurer sent a termination notice to Health Management informing the company that it intended to ax its contracts with the Mississippi hospitals.  Even though BCBS has ended its contracts with the hospitals, Health Management has continued to charge patients covered by the insurer in-network rates, although it may not be able to do so for very long due to financial strain.

During the hearing, Health Management claimed BCBS monopolizes the state's healthcare market and is pushing the hospitals to accept lower payments. The hospital operator says the 10 facilities may have to shut down because of the contract termination and has asked the legislature or the state insurance commissioner to step in to help, according to the report.

On the other hand, BCBS testified that Health Management hospitals overcharge for services, and the possible closures are because of the company's in-progress acquisition by Franklin, Tenn.-based Community Health Systems rather than the BCBS contract. 

Physicians at the hearing backed up Health Management's claims about BCBS having a monopolistic hold on the local market, according to the report.

Lawmakers could attempt to resolve the conflict by passing "any willing provider" legislation, which typically requires managed care organizations to grant network participation to any healthcare providers willing to join and meet the network requirements, according to the report.

More Articles on Mississippi Hospitals:
HMA Still Treating Mississippi Blue Cross Patients as In-Network
Blue Cross of Mississippi Threatens to End Contract With HMA
10 HMA Hospitals Sue BCBS of Mississippi