Four months after Blue Cross Blue Shield of Mississippi went out of network with Jackson-based University of Mississippi Medical Center, the sides have been unable to agree on a new contract, and the dispute now involves a lawsuit alleging a defamatory public relations campaign.
Below is a timeline of the dispute between the provider and payer:
February: The medical center notifies patients that it is negotiating with BCBS of Mississippi over the parties' network contract. The sides need to agree to a new contract by March 31 or BCBS patients will be out of network. The medical center initiated negotiations, asking the payer for higher reimbursement rates.
April 1: BCBS of Mississippi drops the medical center's hospitals, clinics and physicians from its network after the sides are unable to agree on a new contract. In the last 18 months, more than 50,000 patients with a qualifying BCBS plan received care at a medical center facility, a medical center spokesperson told Becker's.
April 21: Mississippi Insurance Commissioner Mike Chaney urges the state's largest hospital and insurer to resolve their dispute, writing that a split would have a devastating impact on patients. The sides agree to go to a mediator on April 27.
May 9: The payer and provider agree to have Walter Johnson serve as the mediator in their dispute. Mr. Johnson, senior counsel at the law firm Watkins & Eager, has mediated hundreds of cases in Mississippi and elsewhere since 1994.
June 7: Mr. Chaney says negotiations have started, but are "moving at a snail's pace."
July 1: A 90-day grace period for in-network care coverage expires, prompting Mr. Chaney to send a letter to BCBS informing it that the state will be conducting an examination to determine whether the company is following state network adequacy regulations.
July 27: Mr. Chaney says the state's insurance department received multiple complaints from patients who have been told by their physicians they cannot receive care at the medical center because they are insured by BCBS. He says he believes that turning away patients would violate a state law that says the medical center “shall be utilized to serve the people of Mississippi generally."
July 28: BCBS sues three medical center executives, alleging they conducted a defamatory public relations campaign against the payer after the contract was terminated.