Blue Cross & Blue Shield of Mississippi filed a lawsuit July 28 in a state circuit court against three executives with the Jackson-based University of Mississippi Medical Center over allegations of a defamatory public relations campaign following a turbulent contract break earlier this year.
The three UMMC employees are LouAnn Woodward, MD, vice chancellor for health affairs and dean of the school of medicine; Alan Jones, MD, associate vice chancellor for clinical affairs; and Marc Rolph, executive director of communications and marketing. The medical center is not named in the lawsuit directly because state law provides it with immunity for defamation committed by its employees, according to a news release shared with Becker's.
BCBS claims UMMC has led a PR campaign "designed to disseminate false and defamatory statements about BCBSMS to the public."
At the heart of the argument, the payer contends that the employees publicly accused BCBS of terminating the contract between the two and excluding, removing or dropping UMMC from its network, thereby preventing members from receiving care at the facility. BCBS said these statements are false, that UMMC voluntarily terminated its contract with BCBS, the public statements harmed the payer's reputation and there was unnecessary confusion around access to care.
The payer said it also committed to maintaining network-level benefits for covered medical services despite the dispute, which stretches back months.
State Insurance Commissioner Mike Chaney believes UMMC is violating state law by turning away patients during the dispute, Mississippi Today reported July 27.
The two parties first notified patients about contract renegotiations in early February over reimbursement rates. By April 1, UMMC was out of network with the state's largest payer. By the end of April and at the behest of Mr. Chaney, the two parties agreed to mediation to resolve the dispute, which is still ongoing.
Mr. Chaney sent a letter to BCBS July 1 to inform the payer that the state would be conducting an examination to find out if the company is following state network adequacy regulations.
Mississippi law requires payers to provide reasonable access to care included in member's policies. UMMC is the state's only safety-net hospital and singular provider of many services, raising concerns that BCBS is not meeting network adequacy requirements and leaving patients with few to no options for covered care.