Insurance Commissioner wants new regs to prevent another UMMC-Blue Cross dispute
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Oct. 5—JACKSON — Insurance Commissioner Mike Chaney has little power in deciding the outcome of the massive fight between Mississippi's largest insurance provider and its largest hospital, but he can use his influence to prevent the health care fallout from happening again.
Chaney, a Republican, told members of the House and Senate Insurance Committee on Monday that because Blue Cross Blue Shield has gone out of network with the University of Mississippi Medical Center and left hundreds of thousands of consumers in limbo, lawmakers need to enact more regulations on network procedures.
The commissioner proposed that lawmakers pass legislation that would stop network contracts between insurance companies and health care providers from being canceled outside of a 90-day window before an open enrollment period.
"It's going to be somewhat controversial, but I want you to keep an open mind," Chaney told the lawmakers.
The open enrollment period for health care coverage begins in November. In the Blue Cross Blue Shield-UMMC dispute, the contract lapsed on April 1, meaning consumers are having to wait around half a year without network benefits to Mississippi's only academic research hospital.
Disagreements over reimbursement rates and Blue Cross' quality care plan led to the dissolution of the contract between the two organizations.
"Everything in life is about money, power and sex," Chaney said. "This is about money."
Blue Cross customers can still seek treatment at UMMC, but since their policy is out of network, they'll have to pay significantly higher fees for treatment.
There are other providers from which customers can seek care, but UMMC is the only academic medical center in the state, and the only facility that offers certain services such as organ transplants.
The four-term commissioner seemed to indicate that the public hospital was using patients as bargaining chips to gain leverage in the dispute, but he added that the insurance company could afford to pay higher reimbursement costs.
"It is wrong for any entity, whether it's the UMMC or any health care provider, to use patients and policyholders as pawns to get more money," Chaney said. "And that's what we have right now going on in the state with this dispute."
Senate Insurance Committee Chairman Walter Michel, R-Madison, told the Daily Journal he thought Chaney's proposal was a "wonderful idea" that would give consumers adequate time to make a change to their policies if they had enough notice about a network cancellation.
"How would anybody say that's a bad idea?" Michel said.
House Insurance Committee Vice Chairman Kevin Ford, R-Vicksburg, was more skeptical of the idea and said he didn't want to give an opinion until he saw the proposal drafted into legislation.
"The devil's in the details," Ford said.
A spokesperson from UMMC declined to comment on the proposal. Representatives of Blue Cross did not immediately respond to a request for comment.
Chaney, a native of Tupelo, said there had been little progress in the dispute, since the parties agreed to a mediator in May to help them resolve the dispute and he had not heard from the mediator since Aug. 29.
Chaney also said he served UMMC with an administrative subpoena for "highly confidential" information about network adequacy, but he wouldn't divulge specifics of what type of information he was seeking.
The 2023 legislative session begins in January 2023.
