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After Blue Cross/hospitals dispute, insurance legislation moves forward

blue crossJACKSON — Insurers would have to accept any medical provider who meets contract terms into their network under a bill moving forward in the Mississippi House.

The House Insurance Committee voted 7-6 yesterday to approve House Bill 553, with four members present but not voting.

The measure comes after a dispute between Community Health Services, which owns 12 hospitals in the state, and Blue Cross & Blue Shield of Mississippi, the state’s largest private health insurer. Blue Cross kicked 10 CHS hospitals formerly owned by Health Management Associates out of its network in 2013, taking the hospitals back Jan. 1. HMA was taken over by Community Health Monday.

Proponents say insurers shouldn’t be able to deny any hospital, physician or other provider willing to meet an insurer’s contract terms and accept its fee schedules.

» READ MORE: Blue Cross Blue Shield expects new owner of HMA’s Mississippi hospitals to help control costs

“If you’ll play by our rules, you can play on our court,” said Rep. Mark Formby, R-Picayune. “That’s what it says.”

Formby said the bill wouldn’t force any provider to join a health insurance network and wouldn’t hurt the ability of insurers to set prices, payment terms or quality standards.

“This puts the patient in charge of his own health care, to be able to use the doctor and hospital of his choice,” said House Insurance Committee Chairman Gary Chism, R-Columbus.

Opponents say the bill will force insurers to pay more as more providers join networks, forcing premiums to rise. Rep. Jeffrey Guice, R-Ocean Springs, said that information showed it would cost the state employee and teacher health plan $15 million more per year.

“Costs have gone up,” Guice said of the experience in other states. “Costs have to be borne by somebody, and that’s the ratepayer.”

Chism did not allow attempts by opponents to amend the bill, saying they could seek changes before the full House.

“I think we’re going to have plenty of time to debate this out on the floor,” he said.

The bill has provoked a titanic lobbying clash at the Capitol, splitting some traditional allies in both the Legislature and the business community. Formby himself is among the House’s most conservative members, but said that navigating issues associated with family members’ medical problems led him to favor the measure.

“There are many of us who are ideologically very, very close, but we see things in different ways on this,” Formby said.

Among those in favor of the bill are Community Health and the medical association, while Blue Cross, the National Federation of Independent Businesses and some hospitals are among the opponents.


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