CHANEY: Bryant call for hearings on BCBS premature

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Published: November 8,2013

Tags: Business, healthcare, hospitals, Mississippi

blue crossMississippi Insurance Commissioner Mike Chaney says in a letter to Gov. Phil Bryant that he thinks Bryant exceeded his authority in directing the Insurance Department to hold hearings on a reimbursement impasse between Health Management Associates and Blue Cross and Blue Shield of Mississippi.

“I am deeply disappointed that you did not rescind Sections 1,2,3 and 6 of this order to the extent to which it directs action by the Mississippi Insurance Department,” Bryant wrote in the Oct. 31 letter.

Bryant waded into the reimbursement dispute last week with an executive order for Blue Cross and Blue Shield to reinstate the Health Management Associates hospitals whose contracts it severed on Sept. 1. With a loss in a court challenge from BCBS, Bryant backed off the reinstatement order. But he kept the part of the order that directed the Insurance Department to investigate Blue Cross’ provider viability and to conduct hearings on the issue.

Q&A-ChaneyChaney said he is investigating the viability of Blue Cross Blue Shields’ provider network on his own volition. But he added that Bryant’s order for the hearings “contradicts certain provisions of the Mississippi Insurance code.”

A hearing can’t be held unless the investigation concludes a violation of the Unfair Trade Act has occurred, according to the commissioner.

“If violations are proven, we will make all remedial action available,” Chaney said in his letter.

Chaney noted that he wants to know specifically what violations the governor had in mind when he alluded in his executive order to a violation of “other laws.”

“We have requested that you provide us with any evidence of such violation and any evidence of an Unfair Trade Practice violation,” Chaney wrote.

He promised Bryant a copy of the report on his examination of BCBS’s provider network.

He further promised that the investigation will be “an in-depth and vigorous review.”

Health Management Associates sued BCBS in June on a claim the insurer owes it $19 million in additional reimbursements. BCBS reacted by severing its ties with HMA. The hospital group is continuing to treat the tens of thousands of BCBS policyholders at in-network rates but insists it can’t continue do so for much longer.

A crack recently occurred in the impasse when Blue Cross agreed to readmit four HMA hospitals –Gilmore Memorial Medical Center in Amory; Northwest Mississippi Regional Medical Center in Clarksdale; Tri-Lakes Medical Center in Batesville; and Woman’s Hospital in Flowood – to its provider network. HMA initially balked at the reinstatement, saying it did not like the terms under which BCBS made it.

Bryant said he believes he could have prevailed against BCBS’s attempt to invalidate his order had he received a hearing the full court. He noted, though, that he thinks more progress can be made on the issue outside of court.

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