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HMA Claims Dispute with Blue Cross is Costing Money and Hurting Patients

By Lawayne Childrey | Published 11 Oct 2013 09:07am | comments

The state’s largest private health care provider says Blue Cross Blue Shield of Mississippi is causing it to lose money. The two companies are at an impasse over how much to charge for services. MPB's Lawayne Childrey reports. 



It's been a little over a month since Blue Cross Blue Shield of Mississippi declared Mississippi's Health Management Association as an out-of-network provider.  Dwayne Blaylock, CEO of HMA's River Oaks Hospital in Flowood, says the action is already affecting patient care.


"When the insurance company that controls 81 percent of the market kicks 10 of their  hospitals out of the network that's going to limit access to healthcare  in Mississippi and certainly we are seeing that. From new borns in NICU, to patients who need their routine colonoscopy to women who need their routine mammogram. we’re definitely seeing an access issue and people are just delaying or just not having those services."


At a joint legislative hearing last month to examine the issue,  Blue Cross attorney, Chris Shapley told lawmakers,  HMA charges exceed other area hospital charges by a substantial amount.


"This is there average charge to Medicare, the federal government. $70, 723, St Dominick's overall charge per case is $29,557,. Mississippi Baptist Medical Center is $36, 367. River Oaks is more than twice as high as these other area hospitals and they want even more money."


The final straw came when Blue Cross dropped HMA from its network after HMA filed a lawsuit over the dispute.  Governor Phil Bryant says he believes there will be some sort of legislation on the issue when lawmakers go back into session this January.


"I've talk to some legislators who are as well disappointed with Blue Cross Blue Shields's reaction to this. I think they should continue to offer  those healthcare opportunities in HMA hospitals that they cover. But to reduce access to healthcare to Mississippian's simply because they are in a legal disagreement with HMA is not fair to the patients or to the physicians that serve them."


There are 10 HMA hospitals in Mississippi and Blue Cross Blue Shield is the state’s largest health insurance provider. Lawayne Childrey, MPB News.




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