Blue Cross, HMA settle dispute

Blue_Cross_Blue_Shield_LogoBy Michaela Gibson Morris and Bobby Harrison

Daily Journal

TUPELO – Blue Cross and Health Management Associates have made peace, ending a dispute that will bring all 10 of the HMA hospitals back into the Mississippi insurer’s network.

HMA agreed to drop its lawsuit that said Blue Cross & Blue Shield of Mississippi was underpaying its 10 Mississippi hospitals, including Amory’s Gilmore Memorial Regional Medical Center.

In response to that lawsuit, Blue Cross had terminated its network agreements with the HMA hospitals effective Sept. 1, citing higher than average costs at many of the for-profit hospitals. In October, Blue Cross reinstated the Amory hospital as well as three other hospitals.

The other six hospitals located in the Jackson metro area, Biloxi and Natchez, will be reinstated Jan. 1.

“HMA regrets this dispute became so negative and impactful to the people at Blue Cross, its members, our own associates, and to our physicians and patients,” said an HMA announcement released Friday afternoon. “This resolution comes after productive discussions, and we are mutually pleased to close this chapter.”

Blue Cross will not be required to pay any money to the HMA hospitals as a result of the settlement.

In a news release, Blue Cross credited the new corporate HMA leadership in reaching the solution.

“In this time of health care reform, there is much more work to do to ensure affordable health care,” read the Blue Cross statement. “We are very hopeful we can work with HMA’s new leadership to focus on shared goals of ensuring quality and managing charges and costs.”

Gov. Phil Bryant, who at one point tried to force Blue Cross to reinstate the HMA hospitals by executive order before he was challenged in federal court, said, “I am gratified that the patients and employees who were impacted by this dispute now have peace of mind in knowing that an agreement has been reached.”

The governor added, “I used my executive authority because negotiations had stalled and patient access to care was threatened.”

Attorney General Jim Hood, who supported the governor’s efforts to issue an executive order, said he was only trying to ensure “people could use the hospitals in the communities where they live.”

Hood said his bigger concern is that Blue Cross has agreed to only a one-year extension to its network agreement with the University Medical Center in Jackson.

“I am not going to let them bully UMC,” Hood said. “I will be fully engaged on that issue.”

Insurance Commissioner Mike Chaney, who opposed the governor’s intervention in the issue, said, “Sometimes it is painful and takes time to resolve differences like these.

We know from experience that when you give private markets time to work out their differences and grievances, these issues can be resolved without government interference. That has proven to be the case here and I am pleased.”

But Chaney said he still will issue a report on whether the Blue Cross network of health care providers ensure it policyholders adequate medical coverage.

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