By Bobby Harrison
JACKSON, Mississippi – Gov. Phil Bryant may not be ending his battle with BlueCross & BlueShield, but instead may be moving the contest to a different venue – a political venue where he has more expertise – the Mississippi Legislature.
Bryant, for whatever reason, decided last week he did not want to fight insurance company BlueCross in the courtroom.
The Republican governor rescinded a portion of a controversial executive order that was requiring BlueCross to reinstate 10 privately owned hospitals across the state into its health care network.
With the rescinding of the order, BlueCross dropped its federal lawsuit challenging the authority of Bryant to issue the executive order.
But in rescinding the executive order, the first-term governor hinted the fight might not be over. “If there is no private or administrative solution to this matter, I expect legislative action during the 2014 session,” the governor said.
House and Senate Insurance committees already have had a meeting to discuss BlueCross’ decision to drop from its network the 10 hospitals owned by Flordia-based Health Management Associates because of a dispute over how much the insurance company should reimburse the hospitals for treating its policyholders.
At that meeting, legislators seemed ready and willing to get involved.
“I hope they can get their disagreement solved before the session begins,” House Insurance Chairman Gary Chism, R-Columbus, said in an Associated Press story. “If it’s not solved, we’re going to have to get involved.”
It would not be the first time a fight involving BlueCross and a Mississippi hospital ended up before the Legislature. In 2004, Tupelo-based North Mississippi Medical Center was locked in a dispute with BlueCross over reimbursement rates.
At the time, BlueCross contended that North Mississippi Medical Center was asking for better rates than other state hospitals. NMMC denied it was seeking a higher rate.
In 2004, by happenstance, two Lee Countians, Democrat Steve Holland in the House and Republican Alan Nunnelee in the Senate, chaired their respective chamber’s Public Health committees. Both took active interest in solving the issue.
Holland and Nunnelee, to a large extent, placed more pressure on the Tupelo medical center to reach a resolution, even to the point of Holland passing through the House a proposal to allow another hospital to be constructed in Lee County.
After intense lobbying by NMMC officials, Nunnelee eventually blocked the new hospital legislation, but in doing so, said to NMMC, “If we don’t see those signs of improvement by next January, I will be the one to introduce the bill. It’s OK for you to be big, but it’s not OK for you to act big.
“You need to act like the small-town institution you once were.”
Eventually, BlueCross and NMMC settled their differences and the Legislature dropped the matter.
This time around, the Legislature might be putting more pressure on BlueCross, thanks in part to a massive public relations plan undertaken by HMA.
Plus, there is a perception by some that BlueCross, by far the largest insurer in the state, is acting as the bully. Sen. Hob Bryan, D-Amory, has taken umbrage at BlueCross’ actions of dropping HMA hospitals, including Gilmore Memorial in Amory, after HMA filed a state court lawsuit against BlueCross, claiming the insurance giant was not making a full reimbursement to its hospitals.
Bryan said he was not taking sides over the reimbursement rate issue, but was upset that BlueCross dropped HMA hospitals for pursuing in court grievances against the insurance company.
BlueCross officials have contended that HMA is asking for a better rate than other Mississippi hospitals receive and that politicians should not get involved in a dispute between two private companies. BlueCross maintains the contract the two sides agreed to gives either the side the right to terminate it.
But Bryant and Democratic Attorney General Jim Hood both argue that state law requires BlueCross to provide adequate health care access to the policyholders in its network. Because of that law, BlueCross has reinstated four primarily rural HMA hospitals, including Gilmore in Amory, in its network at least partially at the behest of Insurance Commissioner Mike Chaney.
Plus, politicians say BlueCross, once a nonprofit but now a mutual company, which means it is owned by its policyholders, has such a large share of the market that it has near-monopoly status and must be treated differently than most private companies.
According to the attorney general’s office, BlueCross insures 81 percent of the large group market, or large employers in the state, 73 percent of the small groups and 57 percent of the individual market.
Those large numbers also guarantee the activities regarding BlueCross catch the attention of politicians.
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