'I'm scared I'm going to freaking die': Mississippi hospital patient speaks out as BCBS dispute continues 

The ongoing contract dispute between the University of Mississippi Medical Center and Blue Cross Blue Shield of Mississippi has left one patient fearful his liver transplant surgery won't be covered by his health insurance at the state's only organ transplant hospital, according to Mississippi Today.

Frank Dungan is a former disaster and emergency planner for the federal government. The 61-year-old Madison, Miss., resident was diagnosed with end-stage liver disease in early 2020. He underwent dual hip replacement surgery, numerous procedures on his esophagus and special tests to qualify as a liver transplant candidate at UMMC. 

The ongoing dispute over reimbursement rates means Mr. Dungan is currently out-of-network for a transplant at the state's only provider that can perform the surgery. He claims BCBS and UMMC will not tell him how much the surgery would cost while out-of-network or how he should proceed.

Mr. Dungan's case manager at BCBS did tell him to get on the transplant list at Memphis, Tenn.-based Methodist Transplant Institute but did not say whether the transplant, follow-up care or rehabilitation would be covered. 

Mr. Dungan said he's reached out to the governor, members of Congress and the state's insurance commissioner. Staff with Sen. Cindy Hyde-Smith and Mississippi Insurance Commissioner Mike Chaney made a few calls, but nothing has materialized.

"What they're doing to him is wrong," Mr. Chaney told Mississippi Today. "He has simply asked for what his estimated cost would be for a transplant. Both parties owe him an answer."

Mr. Chaney has previously called for the two parties to resolve their dispute that affects thousands across the state. In the last 18 months, more than 50,000 patients with a qualifying BCBS plan received care at one of the over 200 UMMC facilities, a UMMC spokesperson told Becker's in March.

In May, UMMC and BCBS did agree on a mediator to help resolve the dispute.

"I'm scared I'm going to freaking die, but that's hard to say," Mr. Dungan told Mississippi Today. "I'm not getting any help."

A UMMC spokesperson told Mississippi Today that transplant candidates "should be able to get a good faith estimate" of what a transplant and follow-up care will cost, but it won't happen "overnight."

A spokesperson for BCBS told Mississippi Today they cannot answer questions about Mr. Dungan for confidentiality reasons, but said federal law requires hospitals to continue providing care for certain patients and accept in-network payments for a certain time period. 

"This would be applicable to transplant patients," the spokesperson told Mississippi Today.

UMMC, however, told Mississippi Today transplant candidates are not considered under this law because a transplant patient's care extends beyond 90 days and requires a lifelong prescription of immunosuppressant medications.  

"You do not want a patient to get a transplant tomorrow and then their insurance [coverage] be gone by July 1, then they’re facing extremely high costs and have no recourse," a UMMC spokesperson said. "That is just not responsible. It's in the best interest of the patients to be listed with a facility they have confirmed … that they will receive coverage for the entirety of their care." 

Mr. Dungan pays nearly $1,200 a month for his policy with BCBS and has already met his $7,000 annual deductible.

His options now are to wait for a contract agreement that may never come between the two parties, or travel to an out-of-state provider that may not accept him as a transplant candidate.

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