Tuesday, October 22, 2013

Governor Bryant orders Blue Cross to reinstate HMA hospitals

Governor Phil Bryant just issued the following executive order :

JACKSON – After Blue Cross and Blue Shield of Mississippi terminated contracts with 10 Mississippi hospitals, Gov. Phil Bryant today issued an executive order requiring that the hospitals be reinstated to the network for about 60 days until an investigation can be done.

"I had hoped the two parties could come to some resolution, but as Governor, I cannot sit back and allow Mississippian's access to care to be threatened in violation of state law," Gov. Bryant said. "It is my hope that a full investigation will ensure that no law has been broken as it relates to a patient's access to care and a provider's responsibility under state law."

According to Executive Order 1327 it provides, first, that the 10 hospitals will be returned temporarily to the network on the same terms on which they operated prior to their exclusion. Second, the Governor's Order provides for the Department of Insurance to complete its ongoing investigation of the hospitals' exclusion and, if appropriate, hold hearings on any violations of the law that are identified.  If the Department identifies no violations, the Order requires it to submit a report explaining why the hospitals' exclusion is consistent with applicable state law. 

The Order provides that the investigation, as well as any required hearings or reports, should be completed within 60 days.  It will then expire automatically seven days after this process concludes.  

The Order issued by Gov. Bryant does not attempt to resolve the parties' dispute over prior payments under their contracts, and it expresses no opinion and has no effect on that issue or their ongoing lawsuit.  Rather, the Order is intended to preserve access to care until a full investigation is complete. 

The Order is based primarily on the Mississippi Patient Protection Act of 1995, which requires BCBS and other insurers to provide their enrollees with "reasonable access to care with minimum inconvenience," and the Governor's constitutional obligation to see that the Act and all other laws of the State are faithfully executed and enforced.  The Department of Insurance's investigation will address whether the hospitals' exclusion from BCBS's network runs afoul of this requirement or violates any other state law. 

Throughout the process, Governor Bryant and his staff consulted extensively with Attorney General Jim Hood and his team, and the Governor expresses his sincere appreciation of General Hood's efforts and willingness to take action to address this issue.

Attorney General Jim Hood said, "While it's encouraging that Blue Cross has allowed four of 10 hospitals back into its network, my hope is that we can bring all parties together, including the Governor and Insurance Commissioner, to resolve this important issue once and for all. That said, the inflammatory comments made by Blue Cross in its legal filings about the governor are unprofessional at best, and are counterproductive to our primary goal -- to protect Mississippians' access to healthcare."

Governor Bryant also appreciates the ongoing efforts to the Department of Insurance and Commissioner Mike Chaney to resolve this standoff, and he stands willing to assist the Department's continuing investigation in any way he can.

As a result of the Governor's Order, the ten affected hospitals will be returned to the BCBS's network under the terms of their prior contracts, and patients enrolled in BCBS's plans may not be required to pay "out-of-network" charges for treatment or care at these facilities.


Sent from my BlackBerry 10 smartphone.

24 comments:

Anonymous said...

Dumb move.

Anonymous said...

I wish Kenneth Stokes would just enter an executive order turning over the insurance to one of his trusted experts.

Anonymous said...

Bryant + Hood = ____?

Anonymous said...

Governor Bryant has a touch of Obama. The truth is 'access to care' is a part of Obamacare. Now we have Bryantcare? Healthcare in many communities is not a marketplace. You have one hospital a half hours drive away and maybe a dentist and a doctor locally if you're lucky.

Anonymous said...

Blue Cross overplayed their hand. They've played the government backed monopoly card for years. It just backfired on them.

Anonymous said...

If the investigation reveals River Oaks consistently charges more than "usual, customary and reasonable" fees will the findings be referred to Dept. of Health for a review of its accreditation/certificate of need?

Anonymous said...

6:08- under what law?

Anonymous said...

6:08 doesn't understand chargemasters.

Phil's Dookie Cleanup said...

Governor's waining testosterone has overloaded his jaybird ass. He has no authority to order this. Period.

Anonymous said...

But he has some fancy cowboy boots with the state seal on 'em, I thought that meant he was in charge

Anonymous said...

The Governor has wide authority under the 1890 constitution. Its a document the late Gov. Long of Louisiana would love. You can write a document and the Secretary of State puts a seal on it and distributes it.

People worry about President Obama creating a police state, but our Governor can spy and order all he wants. Call a special session if he wants to. That is a better move than the orders with the State seal on them.

Lloyd said...

Cliff Finch--now that brings back some memories...um more like nightmares!
I hope King Phil isn't going down that road.

Anonymous said...

What's a blackberry? Is that some kind of new Apple device? Sounds cool.

Anonymous said...

I think the Governor did the right thing.

Anonymous said...

whoever targeted the Governors family should be terminated, wheather it came from the Pigots at BCBSMS or the law firm.

Anonymous said...

Where is Tater, we need a commnet from him!

Anonymous said...

Is other insurance carriers in MS have all of the hospitals in network. At the same time why doctors/ hospitals wont accept certain insurance companies. Is that not an issue with access to care?
I do not understand why it is different?

Anonymous said...

The hospitals are a branch of state government more so than BCBS. Remember the Gov. Barbour hospital tax?

What health insurance company really wants Mississippi underwriting? Think about it.

Anonymous said...

@ October 22, 2013 at 5:51 PM
I believe you are exactly right.

@9:12 PM, I'm behind, I didn't know about this.

KF, thanks for great coverage on this matter. It affects a tremendous amount of people.

Anonymous said...

8:25 pm

The 1890 Constitution gives more power to the Lt. Gov than the Governor. It is a considered a weak Governor Constitution.

And, there are sections in the document that I defy anyone to interpret or explain.

It was written after Reconstruction to put power back in the Delta with the planters.

Any powers the Governor gets to exercise are given to him either by design or default.

There have be efforts to write a new Constitution from time to time for a reason.The last effort was the formation of a large Commission that was inclusive. Brad Dye worked hard to kill the effort and succeeded with Bennie Thompson's help. Dye did not want to lose the stranglehold that he, like Buddy Newman before him, enjoyed and Bennie wanted to retain the power he enjoyed. Politics made for strange bedfellows on the Constitution Commission in the end and that Bennie's committee vote was key and he teamed up with Dye should be a big hint to everyone.

That that doesn't seem the reality this five minutes has to do with electing Lt. Governors who weren't smart enough to understand what their powers were/are. So, power is now in the hands of those who seize it. We've had smart AGs and Auditors who managed to temporarily wield power as a result.

If you don't like the corruption in MS, then you have to start with the 1890 Constitution. You have to read it and conpare it to other state constitutions.


Anonymous said...

I wish Phil would intervene in the the private corporation known as Mississippi Power Co. and order them to reinstate my previous electric bills before the rate hikes by paying for their own Kemper County $5 billion dollar experiment. The most clueless governor in America. He goes down in 2015, count on it freepers.

Anonymous said...

The most recent serious effort to get Mississippi a new constitution ended in defeat in 1988 in the Mississippi legislature. It was an agenda item of then-Gov Ray Mabus and was the only item on his agenda that failed. There is an intricate story behind that episode that has never been told.

That being said, the amendment process is the way to rewrite the antiquated 1890 Constitution. Perhaps some enterprising legislators can begin this process.

Anonymous said...

See what happens when you let Barney put his one bullet in the gun.

Lost In The Archives said...

"...you have to start with the 1890 Constitution. You have to read it and conpare it to other state constitutions."

Like, right, man. Now you've sent me to the library for six months. Next?


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