Attention: Blue Cross & Blue Shield of Mississippi Beneficiaries
(Updated July 3, 2018)
For the past few months, University of Mississippi Medical Center (UMMC) officials have been meeting with representatives of Blue Cross & Blue Shield of Mississippi (BCBSMS) to negotiate a new contract and payment rates UMMC receives for providing health care services to the insured beneficiaries of BCBSMS. After no progress was made, we felt we had no alternative but to notify BCBSMS of our intent to terminate our contract with them effective midnight June 30, 2018.
However, the Medical Center and BCBSMS have agreed to meet in July along with an independent mediator suggested by state Insurance Commissioner Mike Chaney. Leadership from both parties feel it is important to have the mediation complete by the end of July.
BCBSMS’ willingness to come to the bargaining table to work toward a new, fair contract is an encouraging step and one that we hope will lead to a prompt resolution.
With mediation soon to begin and the hope that a reasonable resolution may be imminent, we sent a letter to BCBSMS to extend the contract termination date to August 1, 2018 from the original termination date of July 1, 2018. Unfortunately, BCBSMS did not accept the extension. Nevertheless, as a courtesy to our patients, UMMC will continue to process claims for BCBSMS-insured patients as though they were in-network, even though BCBSMS did not agree to the extension. There is no disruption to your patients' coverage status at this time. We will continue to process claims for covered services as “in-network” until August 1, 2018, while we negotiate.
If the two sides cannot come to a reasonable agreement by midnight July 31, 2018, UMMC will begin to process claims for covered services provided to patients with BCBSMS insurance as "out-of-network." We hope the issue will be resolved by that date so BCBSMS-insured patients will not experience a disruption in their coverage status when receiving care from UMMC.
UMMC's current contract with BCBSMS is 28 years old and was adopted in an era when both UMMC and the health care industry were vastly different. Most troubling, the base contract contains a provision that allows BCBSMS to make any changes it wants to the terms of the contract - including payment rates - without consulting UMMC.
If the two sides cannot come to a reasonable agreement by the August 1, 2018 deadline, beneficiaries can continue to rely on UMMC for their care, but they might incur higher out-of-pocket costs for using a facility and provider that would then be out of network. We apologize in advance for any inconvenience or hardship this may create for you.
Please note, this does not affect employee participants and their dependents in the State and School Employees Health Insurance Plan, which is administered by Blue Cross and Blue Shield. It involves employee groups and individuals who are direct customers of BCBSMS in the commercial insurance market. However, some UMMC employees’ family members are on a BCBSMS commercial plan, and UMMC students who participate in the institution's BCBSMS managed student health insurance plan would also be affected should an agreement not be reached by midnight July 31.
Academic medical centers like UMMC play a unique role in our society. They offer advanced services not available at other facilities. UMMC provides the state's only Level I trauma center, only Children's Hospital, only Level IV neonatal intensive care unit and its only organ and bone marrow transplant services, among many others. We're also the state's principal safety net provider, caring for the sickest of the sick and affording access to all. Our citizens count on these services.
Fair and equitable contracts with our payor partners, like BCBSMS, allow us to keep the physicians and other medical providers, technology, facilities, staff and resources we need to provide the very best care possible to our patients.
We want to assure you that we remain committed to working with BCBSMS to achieve a fair and equitable agreement. In the meantime, we pledge to keep you apprised of our progress and to provide more detailed direction to you if that becomes necessary. We consider this to be a very serious matter or we would not consider this course of action.
Please know that whatever happens, we are here to take care of you and your family. We take our responsibility to the people of Mississippi very seriously and will always keep the needs of our patients at the heart of what we do.
If you have questions about how this action might affect you, please contact Blue Cross & Blue Shield of Mississippi at (601) 664-4590 or 1-800-942-0278.