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Unvarnished behind the scenes look into...

Unvarnished behind the scenes look into UMMC/Blue Cross fight

By: Editor - September 14, 2022

UMMC, media and Blue Cross all look culpable in the mess

A trove of emails and letters obtained via a public records request by Y’all Politics give a unique behind the scenes look as to some of the inner workings of what’s actually happening with Mississippi Insurance Commissioner Mike Chaney, his staff, and representatives from UMMC and Blue Cross in mediating the nearly 8 month fight over network insurance coverage at Mississippi’s largest medical facility.

One thing that immediately jumps out in the document was the assertion from Chaney’s office that in fact in late January, UMMC served notice to Blue Cross that they were terminating the agreement effective on March 31.  UMMC has embarked on a public relations fueled by hundreds of thousands of dollars in money from hospital operations for an initiative that blamed Blue Cross for the impasse.

Example of paid advertising from UMMC against BCBSMS

Y’all Politics has subsequently paid over $1,200 to UMMC in advance of a public records request due from UMMC in the coming days that requests information regarding their communications regarding their media strategy and contacts.

In the public records request provided from MS Insurance Department (MID), there is a combination of:

  • Correspondence between MID, UMMC and BCBS
  • Correspondence with state and federal elected officials and their staff regarding the impact on policyholders and those seeking care
  • Patient stories from all sides, many stemming from complaints directly to MID, about the conduct of both UMMC and BCBS. Many of those stories are presented by one side or the other to essentially weaponize the public narrative.
  • Media requests for comment for stories involving patients that were denied coverage/services. Much of that has been the fodder for stories from Mississippi Today, mentioned extensively throughout the documents.  Earlier in 2022, UMMC embarked on a sponsorship of Mississippi Today podcasts and also purchased advertising through an agency with the outlet as part of a media blitz.  Their lead reporter on this story was previously employed by UMMC.

An example of one of the letters to Chaney is from the administrative head of a local ear nose and throat practice:

We refer patients to the University for anything that Is above our physician’s scope of practice to Include, but not specific, to Pediatric ENT and Head & Neck Cancer Treatment.

Our patients are being told that if they have Blue Cross insurance that they have to pay out of pocket. They will not even give them an out of network payment estimate. Is this alright? can they really do this? The University’s stance is that the patient can pay them then get reimbursed by Blue Cross. A neck surgery estimate equaling $27,000 was recently given to a patient with a $10,000 up front payment being required before surgery. Most of the Mississippi population cannot afford this.

On another note, why are we sending these patients out of state for these services when our teaching facility provides all of them?

What is evident is that this fight between UMMC and Blue Cross is bitter and may not settle soon or easily.  UMMC appears to be contemplating a lawsuit against Blue Cross, but that may require Institute of Higher Learning (IHL) approval, and Blue Cross is currently engaged in a defamation suit with UMMC executives.  The financial stakes in the dispute are potentially hundreds of millions of dollars over time for both UMMC and Blue Cross.  Chaney in his correspondence has alternatively pleaded with both sides collectively to negotiate in good faith and applied leverage to both sides to rectify behavior that is not in the best interest of policyholders and those seeking and essentially being denied care due to excessive financial requirements.

With the media spin somewhat out of control on this matter, it is unlikely that a full presentation of the facts behind the scenes would be otherwise provided by other local or national outlets.  That is why Y’all Politics has made the decision to present the letters and emails in full with only information that might identify members of the public or personally identifying contact information (like direct phone or cell numbers) redacted.  Some of the information identifying patients was redacted by MID.

That information is provided below.

UMMC Blue Cross Blue Shield of MS dispute documents from MID by yallpolitics on Scribd

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