Mississippi's only academic medical center may exit BCBS' network

Jackson-based University of Mississippi Medical Center and Blue Cross & Blue Shield of Mississippi have four days to negotiate new contract terms before the academic medical center goes out of network with the insurer July 1, according to the Clarion Ledger.

Here are four things to know about the contract dispute:

1. UMMC, Mississippi's only academic medical center, and BCBSMS are both preparing for their in-network agreement to lapse. If that is the case, BCBSMS policyholders will lose in-network access to UMMC and may face significant out-of-pocket costs to receive care at the medical center, which includes Batson Children's Hospital in Jackson.

2. A major sticking point is that UMMC's 28-year-old contract with BCBSMS allows the payer to change financial terms of the agreement without notification, Kevin Cook, CEO of UMMC, said in May. While BCBSMS argues UMMC wants to be treated differently than other area hospitals, UMMC has leveraged its status as the only academic medical center in the state, as well as the only children's hospital, as a counter-argument against the insurer.

3. BCBSMS members being treated for an established diagnosis at UMMC would retain in-network access to the health system if the contract ends. This is also true for members with emergencies, according to the Clarion Ledger.

4. In a statement to the publication June 25, BCBSMS said, "At a member's direction of payment, benefit payments will be made to UMMC with the expectation that, in accordance with Mississippi state law, UMMC will provide a payment hold harmless for our members and refrain from balance billing."

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