The reimbursement increase request comes amid similar quarrels between UMMC and Blue Cross Blue Shield of Mississippi.
On Thursday, Mississippi Commissioner of Insurance Mike Chaney told business leaders and politicians gathered at the annual MEC Hobnob event in Jackson that he has been made aware of a new demand by the University of Mississippi Medical Center (UMMC) to an undisclosed managed care company.
According to Chaney, who was one of many speakers at this year’s Hobnob hosted by the Mississippi Economic Council, UMMC has told a Medicaid managed care group that if they do not provide a 15% (an estimated number by Chaney) increase to reimbursements they will possibly remove those that are covered by their plans. This would account for up to 100,000 people, including children, in Mississippi.
“It’s just wrong,” said Chaney.
He added that this practice has never been done in the state of Mississippi but has happened elsewhere.
This is a separate issue from the current dispute going on between UMMC and Blue Cross Blue Shield of Mississippi regarding rate reimbursements. That dispute, Chaney said, is likely at a turning point. He said he anticipates an agreement by Monday.
Managed care companies are contracted through Medicaid and make money by saving the money they receive from the federal government. Chaney said most managed care providers make reimbursements around 104% because they can afford that smaller amount.
Chaney said many of the managed care providers deal with children, because that is where they were directed after they were taken off of traditional insurance plans.
The state’s Department of Insurance does not regulate managed care programs, but the Commissioner said if this reimbursement increase is a trend, it could be an expensive one for the state.
“The problem we run into if that’s the route we are going down that road and the future looks that way, that we are going to demand more money out of Medicaid, it is going to cost the state eventually,” said Chaney.
Medicaid expansion has been a long-discussed option to elevate many of the billing woes for providers. While most in the state’s Republican leadership are against the move, Chaney said he is not opposed to the possibility of expanding Medicaid, but believes it is too late.
“It’s not been popular to say, but I’m not bashful about that,” said Chaney. “I’m in favor of Medicaid expansion when we could have expanded it. I’m not sure it will work today because it’s only got a three-year life left on the expansion part.”
The three-year life remaining means in 2025 anyone who was added to the Medicaid rolls after the expansion will have to find a new “home” unless the federal government changes the current program. Chaney said those decision will be largely up to who is controlling the federal administration at that time.
He said any expansion now may be too late to make a difference.
“We had about 750,000 people on Medicaid, now we have 855,000 and we still haven’t expanded Medicaid. So, when you do the numbers, 855,000 here, 615,000 on Medicare, 967,000 on Blue Cross – and these are all in the trade numbers for the end of 2021 – what United has, what ACA has, you’ve got 200 to 250,000 people uninsured on our books,” said Chaney. “They might be in shared ministries with churches, they may be in other programs, short term duration policies, we don’t know. So, if you expanded Medicaid today you might not add 60,000 people to the rolls. We’re barking up the wrong tree.”
The Commissioner believes the focus should not be on the expansion of Medicaid anymore but how the state plans to deliver healthcare. Chaney said that was an essential reason why the department asked for and promoted telemedicine. He noted that Blue Cross Blue Shield has said they will not be reimbursing anyone for telemedicine past 2020.
Chaney said it is imperative that these issues get resolved quickly since insurance companies are currently in the open enrollment period and any changes could greatly impact patients.
Y’all Politics has reached out to UMMC for a copy of the letter disclosed by Chaney. No response has been received at of this publication.