JACKSON, Miss.–Gov. Phil Bryant issued an executive order on Tuesday requiring that the HMA hospitals affected by the Blue Cross Blue Shield dispute be reinstated to the network for about 60 days until an investigation can be completed.
On Monday BCBS reinstated benefits to four of the ten hospitals where the coverage had lapsed, but that still left thousands of Mississippians in a tough spot.
“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.”
As to the specifics of the order, it says that the ten hospitals will be returned temporarily to the network on the same terms on which they operated prior to their exclusion.
Secondly, it 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.
That investigation will have 60 days to be completed and after that the executive order will expire a week later automatically.
From the press release on Tuesday the Governor’s office states he isn’t choosing a side of the conflict but rather, “the Order is intended to preserve access to care until a full investigation is complete.”
It also states the order is based 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.”
This reasonable access to care is what the Department of Insurance will be looking into during their investigation to see if BCBS has violated that requirement.
Because of the legal mess that has come from the dispute, the Attorney General’s office has been heavily involved in the process.
“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,” said Attorney General Jim Hood. “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.”
BCBS filed a temporary restraining order against Gov. Bryant last week to try and keep him out of the conflict, but since that hasn’t been ruled on yet the Order is legally binding.
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.
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