November 1, 2013 9:59:36 AM
JACKSON -- Mississippi Gov. Phil Bryant is backtracking from part of an executive order he issued in a dispute between the state's largest insurer and a hospital company.
Bryant signed a document Thursday saying he is rescinding the parts of his Oct. 22 order that would have required Blue Cross Blue Shield of Mississippi to resume paying in-network rates at Mississippi hospitals owned by Health Management Associates, based in Naples, Fla.
Bryant is leaving in place parts of his order that require Insurance Commissioner Mike Chaney to finish an inquiry into why Blue Cross excluded HMA hospitals from its network. The insurer originally excluded 10 HMA hospitals but later reinstated four.
Blue Cross sued to block Bryant's action, and U.S. District Judge Henry T. Wingate on Monday granted Blue Cross' request to temporarily block the governor's full executive order from taking effect.
Court records show that Blue Cross withdrew its lawsuit against Bryant on Thursday. The company's attorney said in court last week that the governor doesn't have the power to dictate terms of a contract between two private companies.
"I appreciate Blue Cross's willingness to re-engage in discussions with the hospitals to see whether there is room for a compromise that will benefit all involved, including most importantly the patients that Blue Cross insures and these hospitals serve," Bryant said in a news release Thursday. "I am also encouraged that four of the affected hospitals were recently readmitted to the Blue Cross network."
Wingate had set a Nov. 5 hearing to further explore Bryant's claims of harm that patients would suffer if Blue Cross doesn't contract with the hospitals. That hearing is now canceled because Blue Cross dropped its lawsuit.
"Although my attorneys and I still believe my original order would have more than likely been upheld in full by the courts, continued litigation and potential appeal would stretch well beyond the order's original 60-day expiration," Bryant said. "In light of the cost and time associated with protracted litigation, and because I believe more progress can be made on this issue outside of litigation, I am amending my order to remove those portions contested in federal court."
In federal court last week, an attorney for Chaney said the governor's executive order illegally usurps Chaney's power and the power of the Department of Insurance.
Chaney said in a news release Thursday that his department is "in the midst of an in-depth and vigorous investigation of the adequacy of Blue Cross' provider network," and that the investigation started before the governor issued the executive order.
"As I have stated many times to HMA and Blue Cross since the dispute began, I encourage the parties to come together and find common ground to ensure policyholders have access to affordable care," Chaney said. "To that end, I am happy that this office was able to help facilitate four HMA hospitals once again being paid as network hospitals and give Blue Cross Blue Shield patients access to care."
HMA filed a $13 million lawsuit in June against Blue Cross, saying that the Flowood-based insurance company broke contract terms by underpaying for procedures. Blue Cross has said HMA overcharges. The lawsuit is still pending.
Several days after the lawsuit was filed, Blue Cross gave notice that it was ending its contract with HMA at the end of August. That meant that starting Sept. 1, the HMA hospitals were out-of-network for people with Blue Cross coverage, meaning patients eventually could face higher out-of-pocket expenses. The HMA hospitals have said, however, that they're covering the difference between in-network and out-of-network costs rather than passing those costs on to patients.
Blue Cross said Oct. 21 that it would start paying in-network rates at four of the 10 HMA hospitals: Gilmore Memorial Regional Medical Center in Amory, Northwest Mississippi Regional Medical Center in Clarksdale, Tri-Lakes Medical Center in Batesville and Woman's Hospital in Flowood.
The six HMA hospitals that remain out of the Blue Cross network are River Oaks Hospital in Flowood, Biloxi Regional Medical Center, Crossgates River Oaks Hospital in Brandon, Madison River Oaks Medical Center in Canton, Central Mississippi Medical Center in Jackson and Natchez Community Hospital.
Dwayne Blaylock, president and CEO of River Oaks, issued a statement Thursday for the Jackson-area HMA hospitals, saying they're committed to getting all HMA hospitals back in the Blue Cross network.
"We are encouraged by a growing consensus that communities need protection and patients need access to the health care professionals of their choice," Blaylock said.