BCBS responds to local concerns over UMMC dispute

(courtesy photo)

SDN Editor

The minutes are ticking away leading up to the expiration of the contract between Blue Cross & Blue Shield of Mississippi and University of Mississippi Medical Center in Jackson, the latter of whom just announced an affiliation partnership with OCH Regional Medical Center in Starkville.

The Starkville Daily News reported on Wednesday that UMMC released a statement through the hospital saying the change in network status pertains only to patients with BCBS commercial insurance.

UMMC Director of Public Affairs Marc Rolph said it will not impact employee par- ticipants and their dependents in the State Employees health Insurance plan, including Mississippi State university and Mississippi University for Women faculty and staff. He then said 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.

On Thursday, BCBS responded, saying the participating hospital agreement between Blue Cross & Blue Shield of Mississippi and OCH Regional Medical Center is a completely separate agreement.

BCBS Director of Corporate Communications Meredith Bailess told the Starkville Daily News that BCBS members who receive care at OCH are not impacted by the contract situation with UMMC.

“UMMC continues to be unwilling to work within their existing contract and has chosen to cancel their participating hospital agreements with Blue Cross & Blue Shield of Mississippi beginning July 1, 2018,” she said. “We are currently in non-network transition phase, and UMMC will be a non-network facility effective midnight June 30, 2018.”

Bailess then said BCBS members do not need to worry about the impact of UMMC’s action on their access to care.

“We will continue to provide network-level benefits for medically necessary care received from UMMC and will work with our members to coordinate their care in the most appropriate setting,” she said.

Additionally, she said BCBS has informed its customers and network providers of the upcoming change and how it may impact them.

This includes:

• All emergency care will continue to be covered at network-level benefits.

• Network-level benefits will be paid for members currently receiving medically neces- sary care, those requiring ongoing follow-up or coordinated care at uMMC, and those patients who are newly referred and approved to use uMMC as their provider of choice. Benefits may vary according to a member’s specific benefit plan.

• At a member’s direction of payment, benefit payments will be made to UMMC with the expectation that, in accordance with Mississippi state law, UMMC will provide a payment hold that is harmless for BCBS members and refrain from balance billing.