Bryant Orders BCBS to Reinstate Hospitals

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.

You can download Executive Order 1327 by going to the following link: http://www.governorbryant.com/wp-content/uploads/2013/10/Executive-Order-1327.pdf