Gilmore, HMA challenge BlueCross offer

Blue_Cross_Blue_Shield_LogoBy Michaela Gibson Morris

Daily Journal

AMORY – BlueCross has attached too many strings to its offer to reinstate Gilmore Memorial Regional Medical Center and the three other HMA hospitals to its Mississippi network, officials at the Amory hospital said Thursday.

“We were profoundly disappointed to see that rather than do what their press release suggested, Blue Cross actually sent an entirely new proposal – a proposal with restrictions, conditions and precertification requirements,” said Sherry Pitts, chief executive of Woman’s Hospital in Flowood, which along with Amory’s Gilmore was among the four HMA hospitals BlueCross offered to reinstate.

In a statement, BlueCross said the agreement did not change and is the same required of all network hospitals.

“Blue Cross & Blue Shield of Mississippi did clarify in the reinstatement offers that only those services currently being provided at the hospitals would be considered for payment,” as well as precertification and prior authorization requirements for certain services, according to the statement.

The 10 hospitals owned by Florida-based Health Management Associates have been at odds with BlueCross & BlueShield of Mississippi over reimbursement rates. The hospital system, which includes the Amory hospital, filed suit in June against BlueCross, asserting that they had been underpaid by $18 million. BlueCross maintains the for-profit hospital system’s charges are out of line and terminated the HMA hospitals effective Sept. 1.

HMA hospitals have rallied their communities and launched a statewide media campaign about the termination. On Monday, BlueCross offered to reinstate the HMA hospitals in four towns where they are the only hospitals available.

The BlueCross offer does nothing to address the reimbursement issues, Gilmore officials said.

“Moreover, instead of providing access for our patients to all 10 hospitals, BCBS of MS simply picked four hospitals where Blue Cross is particularly vulnerable politically,” according to the Gilmore statement.

BlueCross accused HMA hospitals of waging a disinformation campaign to distract people from the system’s excessive charges.

“Blue Cross & Blue Shield of Mississippi remains ready to reinstate these four HMA hospitals as Network Hospitals,” according to a statement from the insurance company.

michaela.morris@journalinc.com