A promise not a threat: Gov. Bryant orders BCBS to reinstate 10 hospitals

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Published: October 25,2013

Tags: Business, healthcare, insurance, Mississippi, Obamacare, Tea Party

blue crossJACKSON — Gov. Phil Bryant late Tuesday afternoon followed through on an earlier threat against Blue Cross and Blue Shield of Mississippi by issuing an executive order requiring that the BCBS reinstate 10 Health Management Association hospitals as in-network providers.

The order demands the reinstatement for approximately 60 days until an investigation of BCBS’s actions can be done.

Blue Cross and Blue Shield of Mississippi terminated its contracts with the 10 Mississippi hospitals, including five in metro Jackson, on Sept. 1. The action came after Naples, Fla.-based hospital group Health Management Associates filed a lawsuit in June seeking an additional $19 million in reimbursement for care and treatment of BCBS policyholders. Bryant’s office, through a press statement, emphasized that the order does not attempt to resolve the parties’ dispute over prior payments under their contracts

“I had hoped the two parties could come to some resolution, but as governor, I cannot sit back and allow Mississippian’s access to care to be threatened in violation of state law,” Bryant said. “It is my hope that a full investigation will ensure that no law has been broken as it relates to a patient’s access to care and a provider’s responsibility under state law.”

The Department of Insurance’s investigation will address whether the hospitals’ exclusion from BCBS’s network runs afoul of the state laws pertaining to patient protection or violates any other state law.

Health Management Association has been treating BCBS policyholders as in-network since the severing of the contract, but has voiced doubts it can continue to bear the cost reimbursement losses for much longer.

Bryant’s threat last week to issue the executive order led BCBS to seek a temporary restraining order blocking Bryant’s action. BCBS said it needed the temporary halt to the order in order to seek a permanent injunction. In a filing in the U.S. District Court for the Southern District of Mississippi, the insurer called Bryant’s action “unprecedented” and “flawed and improper on numerous levels.”

Bryant’s office said Tuesday the order demands the 10 hospitals be returned temporarily to the network on the same terms on which they operated before their exclusion.

The governor’s order provides for the Department of Insurance to complete its investigation of the hospitals’ exclusion and, if appropriate, hold hearings on any violations of the law that are identified. If the Department of Insurance identifies no violations, the order requires it to submit a report explaining why the hospitals’ exclusion is consistent with applicable state law.

The order specifies that the investigation, as well as any required hearings or reports, should be completed within 60 days. It will then expire automatically seven days after this process concludes.

Bryant based his order primarily on the Mississippi Patient Protection Act of 1995, which requires BCBS and other insurers to provide their enrollees with “reasonable access to care with minimum inconvenience.” The press statement said the governor’s constitutional obligation is to see that the Act is “faithfully executed and enforced.”

Bryant’s office said the governor and his staff consulted extensively with Attorney General Jim Hood and his team before issuing the executive order.

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