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Tupelo hospital, insurer reach temporary accord

By BOBBY HARRISONNMMC logo

 A temporary agreement has been reached to ensure that  people covered through United HealthCare can continue to receive medical care at Tupelo-based North Mississippi Medical Center and its affiliates.

Mississippi Insurance Commissioner Mike Chaney announced the temporary agreement Thursday. He said it impacts more than 50,000 policy holders.

In October, North Mississippi Medical Center announced that  it was ending its “provider participation agreement” with UHC because it claimed that the national health insurer was not reimbursing the hospital at its contractually agreed rate.

Chaney said Thursday that United Healthcare had agreed to reimburse the hospital at its in-network rates. North Mississippi has agreed not “to balance’ United Healthcare policyholders bills when the hospital does not believe it has gotten contractually agreed-to payments from the insurance company.

The agreement lasts until May 31 as the two sides continue to negotiate, Chaney said.

“This means that all UHC members may continue to be treated at NMMC as they are now without incurring certain financial penalties that might otherwise apply on an out-of-network basis, such as balance billing,” Chaney said. “This action on the part of NMMC and UHC shows that their primary concern is for the patients and consumers they serve.

“I remain hopeful that the parties will reach a resolution of all issues in dispute in the near future.”

The current agreement between North Mississippi Medical Center and UHC was set to end Monday, Chaney said.

The dispute impacts people with employer-based coverage through United HealthCare, as well as those with individual plans. In addition, United covers a percentage of the state’s Medicaid recipients through a managed care program.

The agreement also covers NMMC community hospitals in Pontotoc, Iuka, West Point, Eupora and Hamilton, Ala., as well as North Mississippi Medical Clinics systems and any physicians employed by North Mississippi Health Services, the umbrella organization, as those contracts expire.

Bobby Harrison is bureau chief in Jackson for the Northeast Mississippi Daily Journal in Tupelo. He can be reached at bobby.harrison@journalinc.com

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