Blue Cross, UMMC: Insurance commissioner suspends mediation

Blue Cross, UMMC: Insurance commissioner suspends mediation

Insurance Commissioner Mike Chaney last week suspended mediation between the University of Mississippi Medical Center, the state’s largest hospital, and Blue Cross and Blue Shield of Mississippi, its largest private insurer.

Chaney on Thursday said he made the decision to suspend it indefinitely because “no progress has been reported to my office in the last six weeks.”

Hours later, however, Chaney sent an updated statement to Mississippi Today saying that while he has suspended mediation, “both parties are continuing talks to settle the network dispute and I believe a prompt settlement agreement is possible.”

If no settlement is reached in the “near future,” the dispute will be the legislature and the Institutions of Higher Learning’s problem to solve, he said.

UMMC terminated its contract with Blue Cross earlier this year and officially went out of network with the insurer on April 1. The move has had a massive impact on Mississippians with Blue Cross, particularly those who use services only available at UMMC, including transplant candidates and children in need of specialty care.

“It’s deplorable that the citizens of our state are being used as pawns to settle this dispute,” Chaney said, echoing comments he made to the House and Senate insurance committees at a joint meeting Oct. 3.

Patrice Guilfoyle, director of communications at UMMC, provided an emailed statement.

“UMMC remains engaged in the mediation process with the goal of bringing the dispute to resolution as quickly as possible,” the statement said.

Blue Cross did not respond to a request for comment on this story. Employees of the insurer have not responded to Mississippi Today’s questions or interview requests in several months.

It’s unclear whether the suspension is a result of the two parties reaching an impasse or because they haven’t communicated with Chaney’s office in over a month.

Speaking to legislators, Chaney also referred to complaints his office has been getting from consumers, which he called “horrendous.” Emails to the department show a parent of two children with cancer and kidney disease describing how the family is facing paying “significant out of pocket costs” to continue getting care at UMMC.

“Going out of state for care requires time off of work and time missed from school. It also means establishing new relationships with physicians and other medical staff,” the parent, whose name and other identifying information were redacted, wrote.

Chaney also told lawmakers that he would be pushing legislation in 2023 to restrict insurance companies and hospitals from terminating contracts more than 90 days before open enrollment on the federal marketplace.

“I will be pursuing legislation in the 2023 Legislative Session to protect consumers in the future from getting caught in the middle of these types of contract disputes,” Chaney wrote in the Oct. 7 letter to UMMC and Blue Cross leadership announcing his decision about suspending mediation. “I told a joint Legislative Committee at a hearing … that MID had not been updated since late August on any progress in the mediation process and that we would pursue legislation. I now find that both parties are opposed to any consumer protection legislation and are lobbying legislators.”

In April, Chaney urged the two parties to bring in an expert and impartial mediator who could preside over the negotiations, which focus mainly on reimbursement rates and the insurance company’s quality care program. The two parties agreed on a mediator — Walter Johnson of the Jackson law firm Watkins & Eager — in May. Mediation officially began in June.

The two parties used the same process during their last contract dispute in 2018, and it took around 10 days to come to an agreement.

Under state agency rules, Chaney is not allowed to directly mediate or help settle disputes.

Editor’s note: Kate Royals, Mississippi Today’s community health editor since January 2022, worked as a writer/editor for UMMC’s Office of Communications from November 2018 through August 2020, writing press releases and features about the medical center’s schools of dentistry and nursing. A longtime journalist in major Mississippi newsrooms, Royals had served as a Mississippi Today reporter for two years before her stint at UMMC. At UMMC, Royals was in no way involved in management decisions or anything related to the medical center’s relationship or contract with Blue Cross and Blue Shield of Mississippi.







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