Hospital asks for deadline delay 9/3/2013

Published 12:00 am Tuesday, September 3, 2013

Hospital asks for deadline delay

By John Howell Sr.
Tri-Lakes Medical Center and nine other Mississippi hospitals have asked Blue Cross/Blue Shield of Mississippi (BCBS-MS) to extend a September 1 in-network termination deadline by 60 days.

In late June, BCBS-MS notified the ten Health Management Associates (HMA)-owned hospitals that after September 1 they would no longer reimburse hospitals for treatment of BCBS-MS-insured patients at in-network rates. Instead, BCBS-MS would reimburse hospitals at out-of-network rates, potentially creating higher out-of-pocket costs for the patient.

An August 27 letter from HMA CEO Bill Williams to BCBS-MS CEO Carol Pigott cites a June 18 lawsuit filed by HMA against BCBS-MS that alleges the insurance company failed to pay over $17 million to HMA hospitals for health services to BCBS-MS members. Ten days later, BCBS-MS announced the termination of the ten HMA hospitals as eligible for in-network patient reimbursement.

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“Let’s not put Mississippians in the middle of our legal dispute,” Williams states in the letter.
“If BCBS-MS agrees to extend the contracts for 60 days and be willing to come to the table in good faith to discuss our issues, our hospitals will be willing to back of the lawsuit and stay its proceedings for 60 days — to allow more time to resolve our differences.”

Meeting with Batesville’s mayor and aldermen August 6, Tri-Lakes CEO Wes Sigler told city officials, “If we do come out of network, and we are out-of-network with particular employers, our intent is to hold the patients harmless to that.

“If we can determine what you would have paid as an in-network (patient), that is what we would hold the patients accountable for,” he continued.

“We’ll just have to take the lower, … out-of-network payment that we would get from Blue Cross.”
City of Batesville employees are insured through BCBS-MS.

On August 30, HMA had not received a reply from BCBS-MS about the proposed 60-day deadline extension, according to the Clarion-Ledger.

HMA spokeswoman Kace Ragan told the CL that HMA hospitals intended to work with BCBS-MS-insured patients to keep from putting the extra out-of-network cost on them, but she said that the position could be difficult to maintain long-term.