Insurance commissioner Mike Chainney said the University of Mississippi Medical Center (UMMC) believes it violates state law by keeping patients away from the state’s only safetynet hospital.
According to Chaney, the state insurance department has received many complaints from UMMC patients who were told by their doctors that they could not be treated in the hospital because they were insured by Blue Cross and Blue Shield in Mississippi.
Since April 1, UMMC has been out of the network with Blue Cross, the state’s largest insurance company, due to disagreements over repayment rates and Blue Cross’s quality care plans.
Mr. Chaney believes that UMMC’s alienation of patients violates Mississippi Code 37-115-31, which states that UMMC “should be used to serve the people of Mississippi in general.” Said.
“If you are a university hospital, you have a moral and ethical obligation to take care of the Mississippian culture, and you are legally required to do so,” says Chainy.
Chaney said his office had forwarded some of these allegations to UMMC and “other appropriate authorities capable of enforcing the law.”
Under federal law, public hospitals like UMMC cannot refuse patient care based on their ability to pay or who the insurance company is. UMMC and BlueCross continue to respect the in-network charges for BlueCross patients coming to UMMC’s emergency room. Mississippi Today has not independently identified a case of UMMC that keeps patients away in an emergency.
Under UMMC’s official policy, patients are aware that each Blue Cross customer will not accept payments from Blue Cross for selective services and will incur medical costs if they continue treatment at the hospital. You need to sign a form to verify that you are there. .. Chaney claims that it is unclear whether this policy is adhered to in each BlueCross patient.
“The problem is that the people at the top we’re dealing with (at UMMC) tell us one thing when what’s happening at the bottom is quite different from what they’re telling us. That’s what it is, “Chaney said.
UMMC spokesman Marc Rolph said the hospital was “no comment” on Chainy’s allegation that UMMC violated state law.
Federal law required that UMMC continue to respect in-network charges for certain patients for 90 days after leaving the network, but its “continuation of care” grace period ended on July 1. Transplant patients are forced to seek out-of-state care or switch to another insurance company.
Chaney also previously claimed that BlueCross violated network adequacy requirements without UMMC on the network. UMMC offers a number of specialized services not found anywhere else in the state, such as children’s cancer treatment and porting programs. State law requires Blue Cross customers to have reasonable access to these services if they are covered by an insurance plan.
Chaney launched a network validation review of Blue Cross on July 1st. The results may not be finalized or published for several months.
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