UMMC: Contract disputes will not impact OCH patients


OCH Regional Medical Center

By: 
RYAN PHILLIPS
SDN Editor

The decision by county-owned OCH Regional Medical Center to pull the trigger on an affiliation with Jackson-based University of Mississippi Medical Center on Tuesday was met with concerns from some in the community regarding UMMC’s contentious relationship with Blue Cross & Blue Shield of Mississippi (BCBS).

UMMC in May announced its plans to terminate the contract with the insurance provider at midnight on June 30 if a new contract between the two entities could not be reached.

If no contract agreement is made, UMMC has said customers will still be able to receive care in the system, but may receive higher out-of-pocket costs.

Accordingly, UMMC would be considered “out-of-network” with the insurer effective July 1, according to a statement from the hospital system, which announced its affiliation with OCH Regional Medical Center following Board of Trustees approval during a joint meeting with Oktibbeha Counter supervisors on Tuesday.

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OCH released a statement by UMMC Director of Public Affairs Marc Rolph on Wednesday, who said this change in network status pertains only to patients with BCBS commercial insurance.

“It does not impact employee participants and their dependents in the State Employees Health Insurance Plan, including Mississippi State University and Mississippi University for Women faculty and staff,” Rolph said.
 
Rolph then said the affiliation will have no effect on OCH’s current relationship with Blue Cross & Blue Shield of Mississippi, even if UMMC goes out of network with Blue Cross.

Oktibbeha County supervisors contacted about the issue declined to comment due to a lack of familiarity with the contract disputes, but Board President Orlando Trainer said he hoped a resolution could be made, even if it doesn’t impact OCH.

“I just hope they get everything resolved and everybody gets what they want and they can reach a compromise,” he said.  

Mississippi Commissioner of Insurance Mike Chaney recently weighed in on the contract dispute, saying his primary concern is that patients continue to receive access to quality healthcare without suffering financial penalties. 

Conversely, as Commissioner of Insurance, Chaney is prohibited by regulation from acting to mediate or settle disputes between a health carrier and a medical provider arising under a provider contract. 

“I urge both BCBS and UMMC to work diligently to find common ground prior to the June 30th termination date,” Chaney said in a statement. “It is my expectation that should the contract actually terminate, BCBS will continue to pay network benefits and UMMC will refrain from balance billing patients until the parties resolve their differences.”

Healthcare.Gov defines balance billing as when a provider bills a patient for the difference between the provider’s charge and the allowed amount.

“For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30,” the website says. “A preferred provider may not balance bill you for covered services.”

The Clarion Ledger in Jackson reported on Wednesday that UMMC and Blue Cross had come to a standstill concerning contract talks, with the Jackson newspaper saying the teaching hospital is requesting higher, set-in-stone payment rates that factor in its place as the state's only academic medical center.

It was also reported this week that Blue Cross has said UMMC has been uncooperative and has not earned special treatment.

 

 

 

 

 

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