Judge blocks governor’s attempt to force Blue Cross to pay in-network rates
by Associated Press
Published: October 29,2013
Tags: bench, Blue Cross & Blue Shield of Mississippi, court, David Kaufman, Dwayne Blaylock, Gilmore Memorial Regional Medical Center, health, health benefit, health care, health insurance, Health Management Associates, Henry T. Wingate, hospital, judge, justice, medical, medicine, Mick Bullock, Mike Chaney, Mississippi Department of Insurance, Northwest Mississippi Regional Medical Center, Phil Bryant, public health, Tri-Lakes Medical Center, Woman's Hospital
JACKSON — A federal judge yesterday blocked Gov. Phil Bryant from compelling Mississippi’s largest health insurer to resume paying its in-network rate to a chain of 10 hospitals.
U.S. District Judge Henry T. Wingate read a temporary restraining order from the bench saying Bryant didn’t provide enough proof to justify an executive order he issued last week.
Bryant’s executive order would have required Blue Cross & Blue Shield of Mississippi to resume paying in-network rates at hospitals owned by Naples, Fla.-based Health Management Associates, starting today.
Wingate set a Nov. 5 hearing to further explore Bryant’s claims of harm that patients would suffer if Blue Cross doesn’t contract with the hospitals.
“The executive order leans heavily on threatened harm verified primarily by anecdotal assertion,” Wingate said. “The hearing will determine the facts undergirding those assertions.”
Wingate emphasized that he was not calling Bryant’s order illegal. However, he said that Blue Cross had met the legal hurdles for him to freeze the current status and keep six hospitals owned by HMA out of the insurer’s network.
Blue Cross, under pressure from Bryant and state Insurance Commissioner Mike Chaney, reinstated four of the 10 HMA hospitals last week — Gilmore Memorial Regional Medical Center in Amory; Northwest Mississippi Regional Medical Center in Clarksdale; Tri-Lakes Medical Center in Batesville; and Woman’s Hospital in Flowood. HMA says it’s still paying the difference between in-network and out-of-network rates for HMA patients covered by Blue Cross, shielding them from higher bills. Though Blue Cross administers the state employee health plan, it has a separate network and isn’t affected.
The insurer sued Bryant Oct. 18 after he sent the company a letter saying he intended to issue the executive order covering all 10 HMA hospitals. Three days later, Blue Cross put the four hospitals back in network, but Bryant went ahead and issued his order Oct. 22.
Blue Cross argued before Wingate that Bryant’s order was unconstitutional, saying the governor should have given the insurer a due process hearing, couldn’t constitutionally force it to contract with another business, and was violating federal equal protection mandates.
Bryant had said that without the hospitals, Blue Cross would have an insufficient network under a state law meant to protect patients.
Blue Cross attorney David Kaufman characterized the ruling as a victory.
“We believe, and the judge, I think, has concluded, that our constitutional rights were violated,” he told reporters after the ruling.
Chaney had intervened in the lawsuit to argue that Bryant was overstepping his authority by issuing orders to the separately elected fellow Republican.
Bryant spokesman Mick Bullock said Bryant still believes the order was legal and within the governor’s authority.
“This is certainly part of the legal process,” Bullock wrote in an email. “The governor will evaluate the court’s ruling and will continue to work with Attorney General Jim Hood to resolve this matter.”
Blue Cross, which had attacked Bryant personally in its lawsuit, was more conciliatory Monday.
“Despite a difference of opinions in this current situation, we feel certain that we share a common goal with Governor Bryant — to create a healthier state and a brighter future for all Mississippians,” spokeswoman Meredith Virden said in a written statement.
HMA, for its part, restated its desire to negotiate with Blue Cross. The hospital operator sued Blue Cross in June in state court for imposing a contract HMA hadn’t agreed to, leading Blue Cross to terminate contracts with all 10 hospitals.
“We will continue to attempt to work with Blue Cross Blue Shield of Mississippi to get all hospitals back in network,” said Dwayne Blaylock, CEO of River Oaks Hospital in Flowood, one of the six that are excluded.
The other five still out-of-network are Biloxi Regional Medical Center, Crossgates River Oaks Hospital in Brandon, Madison River Oaks Medical Center in Canton, Central Mississippi Medical Center in Jackson and Natchez Community Hospital.
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