Insurance Commish Mike Chaney issued the following statement.
The Mississippi Insurance Department learned this week that Southwest Health System located in Pike County, Mississippi will drop its Wellcare Medicare Advantage agreement at the end of the year.
Once the Medicare Advantage network agreement ends, some visits would be considered out-of-network and policyholders would receive reduced benefits.
Insurance Commissioner Mike Chaney said, “We do not regulate Medicare Advantage plans. That’s the federal government. We do, however, get involved to protect the consumer because it’s such a hot button issue. From what we understand, Wellcare has over 30,000 Advantage consumers in the state. They tell us that they only have 800 in Pike County and that they are working to secure several facilities that will see Wellcare patients within 10 miles of the hospital.”
Patients may go to other in-network hospitals in the area including: Kings Daughter Medical Center, Walthall County General Hospital, and Marion General Hospital.
A similar situation is playing out in Tupelo. North Mississippi Health System is ending a multi-year Medicare network agreement with Humana on December 31, 2018. Humana has reported that negotiations with the hospital, started in June 2018, have been unsuccessful.
Commissioner Chaney says this is an example of reimbursement issues.
“We’ve had 5 hospitals close since 2013 and four have filed bankruptcy in the past three weeks. There will be more if we don’t get a handle on the problem,” Chaney said.
Alternative in-network hospitals in North Mississippi include Baptist Memorial Hospital with several facilities, OCH Regional Medical Center in Starkville and Trace Regional Hospital in Houston, MS.
Patients should consider other healthcare plans but they need to do so quickly. Medicare Open Enrollment started October 15th and continues through December 7, 2018. Once enrolled in Medicare, consumers can choose supplements or Medigap for expenses not covered by Medicare.
Consumers can visit www.mid.ms.gov to look at Medicare plans and shopper’s guides.
Those with questions for Wellcare should call the Customer Service number on the back of their insurance card.
Humana Medicare providers in North Mississippi with questions or concerns should call the Humana customer service toll free number (800) 457-4708.
Humana Medicare members in North Mississippi with questions or concerns should call the toll-free phone number on the back of their Humana ID cards.
Kingfish note: Has anyone noticed how many hospitals in Mississippi are losing money? Numerous county and rural hospitals are running in the red. However, the big boys aren't doing too well, either. MBMC was losing millions of dollars before it merged with the Baptist system in Memphis. It's no secret UMMC is losing money thanks to budget cuts. It's also a safe bet that St. Dominic wasn't taken over by the Our Lady of the Lake system in Baton Rouge because it was doing so well.
So when do our so-called leaders start talking about this problem?
20 comments:
Our leaders are talking about the healthcare issues. They don't think you should have healthcare unless you can afford to pay out of pocket to a private provider. They think it's socialist to help people.
Maybe if self inflicted obesity related issues would quit flushing taxpayer dollars down the drain Medicare and Medicaid could afford to reimburse those doctors and hospitals in a timely fashion. Ask the bankrupt hospitals what percentage of their patients are in for issues caused by being morbidly obese and/or noncompliant diabetics. Taxpayers pay for them to become obese through SNAP when they buy soft drinks and carb heavy processed food, then have to pay for their treatment through Medicaid and Medicare.
@12:23- it’s the very act of TRYING to socialize medicine that created the situation to which these hospitals have succumbed. It is BECAUSE they are providing healthcare FOR WHICH THEY ARE NOT GETTING PAID that is bankrupting them. How can they pay THEIR BILLS ....the doctors, nurses, x-ray techs, etc. and pay the light/water bills, and buy the machines, buildings, bandages and medicines necessary to make sick people well if they aren’t getting paid for having provided that medical care????
"Coverage" for pre-existing conditions is not insurance. It is welfare.
They wont talk about it because calling a spade a spade is frowned upon these days and you get called all kinds of names. Plus its bad for job security(re-election). Truth is medical care is expensive and to be forced to do work for anyone who enters your door and not get reimbursed in full or paid at all costs the hospitals money. At the end of the day both hospitals and insurance companies are not Non Profit entities like the socialists would like for them to be. Going to the ER for a common cold so you don't use your Medicaid visits hurts the hospital and other patients in the end.
@2:06 Excellent post....on the mark.....but will be rapidly changing over the years to come. The question should be in these articles: Who was behind the capital expenditures that built these facilities that didn't have true long term viability? Seems like there's a lot of things like this in Mississippi that don't serve a purpose except for a Roger Wicker type to cut a ribbon and claim responsibility for it getting built, just so they can garner votes.
Kingfish note: Has anyone noticed how many hospitals in Mississippi are losing money? Numerous county and rural hospitals are running in the red. However, the big boys aren't doing too well, either. MBMC was losing millions of dollars before it merged with the Baptist system in Memphis. It's no secret UMMC is losing money thanks to budget cuts. It's also a safe bet that St. Dominic wasn't taken over by the Our Lady of the Lake system in Baton Rouge because it was doing so well.
OK - We should immediately fire the management teams and any people working on the financials. We should also see to it that staff is cut (especially the damned slackers), salaries and benefits are reduced and....WAIT...I thought this was the PERS thread.
Lot of nonsense explanations on here. Most of this nonsense can be cleared up by separating quality of healthcare from payment for healthcare. Advances in quality have led to ambulatory services drastically reducing hospital occupancy. The rural hospitals are insolvent because the rooms are empty. The rooms are empty because the quality of many medical procedures no longer requires hospitalization. Therefore, the revenue stream is gone and the rural hospitals can longer pay for operating rooms that can be mass produced elsewhere. This has nothing to do with insurance coverage. These rural hospitals should not be subsidized any more than a dying shopping mall should be. Yep, you are going to have to travel somewhere else to get your spleen removed. However, the bigger quality of care issue that you are all missing is the stunning number of medical errors that are occurring in these big medical centers all across the U.S. That’s where you ought to be alarmed.
“Coverage” for pre existing conditions is not welfare fool...it’s spreading the cost of illness among a larger sect so people can live.
I sincerely hope your entire family has cancer of the fingers and they need help but can’t get it.
Remember we support existing conditions.,.
No, 7:19, compelling me to pay money into a group to take care of others with pre-existing conditions is not insurance; it’s tyranny. If I choose to pool my resources with thirty other families and we agree to only provide for future medical events that each exceed $10,000, that is our business and no one else’s. If my children get cancer of the fingers (which apparently you wish that they do) and my group does not have enough funds to pay for treatment, then I and my children suffer the consequences of my decision. The idea that I then have some right to a higher level god who will compel others to pay for the cancer treatment is not only ridiculous, it is confiscation. Plus, it means handing over my welfare to this god and this god’s rules. On the other hand, if you have children with cancer and no alternatives, I can choose to help you or not choose to help you. It’s called charity. However, you have no right whatsoever to my assets.
How much money has just the pain cream operation out of Hattiesburg cost us? Millions from just one small group. Provider fraud is a huge issue but it is white collar so we largely ignore it.
We grossly overpay doctors compared to every other Western nation.
https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-disparities-000557
you could go a long way towards ending the obesity epidemic by removing government corn and beef subsidies. Your 99 cent McDonald's cheeseburger will now cost much much more.
I think there is a unique solution to kill a few birds with one stone. We have a massive overpopulation issue that affects everything. It is depleting all our natural resources and ruining the environment. Clearly our older population is a drain on our healthcare as they are living too long and driving up costs. We should just cut people off at 60 from pharmaceuticals and expensive treatments. That will do away with Medicare like the right wants and fix the environment like the left wants. Everybody wins!
Devil's advocate here: If so-called pre-existing conditions were not covered by HIPAA regulation, upwardly mobil folks with an illness would be dead in their tracks as far as changing jobs. You'd be hesitant to switch careers or take a job with another employer in order to advance in your chosen field.
The 'P' in HIPAA simply means that insurance coverage from one job to the next is 'portable'...insurance coverage can't be denied if you change jobs (in a nutshell).
Nobody is 'sticking it to' the pool-snobs who think they're in a safe capsule with people having zero illnesses.
Let's take a look at this comment:
"Coverage" for pre-existing conditions is not insurance. It is welfare. October 30, 2018 at 3:29 PM
So...if the person who posted that is, say, an accountant and manages to get an MBA and searches the job boards and applies for a position as a Senior Auditor or Accounting Manager at another company and he gets that job....and he happens to have two heart stents and is on three control meds....He is going on welfare if the new employer's plan covers him?
I agree with 2:06. We should outlaw sodas, sugar, trans fats, high fructose corn syrup and other plagues on the state's citizens' diets. Maybe if we outlawed mcdonalds and wendys, we could get these costs under control. It's clearly not working to let people make their own dietary decisions.
Prior to HIPPA most Group plans waived pre ex on new employees who had prior coverage. Granted individual plans did not. The issue is and the reason for the mandate was to attempt to prevent individuals from waiting until they nad an issue before buying coverage. What if you could wait until your house was on fire, damaged by a storm before you bought coverage.
There are ways to correct the issues but getting all parties, Users, providers (Drs, Hospitals, big Parma) insurance, and. Govern,ent to agree seems impossible
That's not stringent enough 5:45 PM.
Required periodic weigh-ins for the obese with mandatory loss targets. Miss your weigh-in or target, suffer a fine or loss of benefits or both.
If we're forced to pay then everyone with lifestyle inflicted health care problems are forced to pay.
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