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Blue Cross, UMMC agree to mediation to settle contract dispute

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Blue Cross, UMMC agree to mediation to settle contract dispute


Blue Cross & Blue Defend of Mississippi and College of Mississippi Medical Middle have agreed to make the most of a mediation course of to settle the contract dispute that has left the state’s largest hospital out of community with its largest insurer.

The choice comes after Mississippi Insurance coverage Commissioner Mike Chaney despatched them a letter on April 21 urging them to conform to mediation. The arbitration course of entails bringing in an skilled and neutral mediator who can preside over new contract negotiations. 

Chaney advised Mississippi Right now on Thursday that he’ll be offering a number of suggestions for potential mediators by subsequent week. 

Blue Cross and UMMC used the identical mediation course of to settle their final contract dispute in 2018, and it took round ten days to strike a deal, Chaney stated. At the moment, Blue Cross agreed to take away language that made the contract evergreen, that means the insurance coverage firm may now not change the contract phrases at any time.

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UMMC claims that between 2014 and 2017, Blue Cross made annual modifications to their reimbursement charges that decreased the general reimbursement UMMC obtained to look after Blue Cross sufferers.·UMMC obtained an general 1% improve as a part of the 2018 negotiations, however no modifications have been made to their reimbursement charges since then.

After the 2 events agree on who the mediator needs to be, a deadline will likely be set for them to settle their variations.  Chaney advised Mississippi Right now that the deadline will seemingly be  June 1 – 30 days earlier than the top of the 90-day “continuity of care” interval, the place sure Blue Cross sufferers can nonetheless obtain care at UMMC and have their insurance coverage accepted. 

Beneath state company guidelines, Chaney shouldn’t be allowed to straight mediate or assist settle disputes over contacts between insurance coverage corporations and well being care suppliers.

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Chaney’s involvement stems from considerations that UMMC not being in Blue Cross’ community runs afoul of state community adequacy laws because of UMMC offering providers that can’t be discovered elsewhere within the state, similar to its organ transplant unit and youngsters’s hospital.

BCBSMS maintains that even with out UMMC, it’s nonetheless assembly its community adequacy requirement. BCBSMS additionally stated that the treatment in a state of affairs the place community adequacy is a matter is for it to offer community degree advantages to its clients for these providers, which it has provided to do by directing its members to signal a written course of fee instructing the insurer to pay the hospital. 

UMMC has declined to just accept these funds from BCBS, arguing that it could permit BCBSMS to proceed paying at unsustainable charges. 

UMMC and Blue Cross haven’t been in communication since April 1, when UMMC formally went out of community with the insurance coverage firm, in line with officers from each entities. Tens of hundreds of Mississippians – a few of them gravely in poor health and others in want of superior specialties solely obtainable at UMMC – are caught in the midst of the dispute.

Although the 2 events have had related contract disputes in earlier years, that is the primary time UMMC has been faraway from BCBSMS’ community. 

In consequence, tens of hundreds of Mississippians have been left to face greater out-of-pocket medical bills or discover care elsewhere. Potential transplant recipients who’ve spent months or years on organ donation waitlists have been positioned on maintain. Mother and father of youngsters who require specialised care that may solely be offered at UMMC’s youngsters’s hospital have been left with expensive and inconvenient choices for persevering with their baby’s care. 

UMMC is asking Blue Cross for substantial will increase to inpatient, outpatient {and professional} reimbursement charges, some as giant as 50%. Total reimbursement from Blue Cross would improve by round 30% within the first yr of the brand new contract. 

Mississippi has the bottom reimbursement fee from industrial insurance coverage corporations for inpatient providers within the nation, in line with a 2021 white paper by the actuarial and consulting agency Milliman. Whereas UMMC maintains that BCBSMS is paying them effectively under market charges for different tutorial medical facilities within the area, BCBSMS argues that agreeing to the will increase would necessitate vital premium will increase for his or her clients – regardless of a Mississippi Right now investigation that exposed the insurer is sitting on an infinite reserve of cash.

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This week in politics: Why Democrats didn’t vote for Kamala Harris in Mississippi as they’ve done in previous years

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This week in politics: Why Democrats didn’t vote for Kamala Harris in Mississippi as they’ve done in previous years



Hyde Smith not interested in US Sec. of Ag, and US Rep. Michael Guest once again in national spotlight last week.

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Ever since Donald Trump won a lopsided victory over Vice President Kamala Harris, many have been researching how she lost by a worse margin than sitting President Joe Biden. 

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The answer might be as simple as this: Some Democrats simply didn’t vote, and that trend was true in Mississippi. 

Analyzing election data from Mississippi and the nation, turnout was low across the board, but the GOP won by a larger percentage of ballots cast in the state than in some previous presidential elections.  

According to Dallas Breen, the Stennis Institute’s executive director, many Democratic voters in swing counties did not see enough of a separation between Harris and Biden.

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Not wanting to vote for Trump but also not seeing a reformer in Harris, many Mississippi Democrats just decided to stay home on Election Day, Breen said. 

“From what we are seeing, you just had a lot of 50/50 counties, and there was a bigger drop off of Democrats not coming to vote than Republicans,” Breen said. “In years past, Democratic candidates were typically disconnected from that because they were senators, secretaries of state, etc.” 

That theory is also illustrated by the fact that Trump won six Mississippi counties that went for Biden in 2020, including some in the Delta.

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Hyde-Smith throws cold water on Sec. of Agriculture rumors

 Early last week, Sen. Cindy Hyde-Smith, a Republican, finally spoke on what state politicos had been wondering for weeks: Will she become the next U.S. Secretary of Agriculture? 

Her answer may not have a huge ripple effect, but it did reaffirm her bid for reelection in 2026.

“It’s an honor to be mentioned as a potential nominee for Secretary of Agriculture, but my plans are to remain in the Senate and continue to deliver for the people of Mississippi,” Hyde-Smith wrote in a press release. “As a former state agriculture commissioner and with my current committee assignments, I remain wholeheartedly committed to the ag community, its growth, and its success.” 

With Hyde-Smith out, the question remains if any Mississippi politician will get a seat at Trump’s table. Whether that comes through an appointment or semi-regular trips to the White House over the next four years remains to be seen.  

Mississippi US House Rep. at center of AG pick drama

For the second time since taking office, U.S. House Rep. Michael Guest, R-Dist. 3, took the national spotlight, though it was likely unwanted.

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Guest, who chairs the House Ethics Committee, told reporters Wednesday afternoon that a report on Trump’s now-former U.S. Attorney General pick Matt Gaetz’ alleged sexual misconduct and drug abuse was not going to be released.  

Over the last week, many had called on the committee to release the report to the Senate so when Gaetz came before an appointment committee, it would have all the facts. Others called on the Senate not to approve of the pick altogether.

House Speaker Mike Johnson, a Republican from Louisiana, had said since Gaetz resigned from Congress when Trump appointed him, the report could not be released. Gaetz bowed out of the appointment on Thursday.

Guest did not respond to requests for comment on the Gaetz report. Nor did Sen. Roger Wicker or Hyde-Smith respond to whether they would vote to approve Gaetz’ appointment if it came before the full Senate. 

“Democrats would have never nominated a candidate like Gaetz to anything,” U.S. House Rep. Bennie Thompson, D-Dist.3, said in a statement to the Clarion ledger about the former AG pick. “(Gaetz) demeans the office of Attorney General. Shame on the Republicans for embarrassing themselves.” 

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Branning sues election commissioners to pressure on-time ballot counting

As of the afternoon on Nov. 15, the Hinds County Election Commission had yet to send its final tally of absentee and affidavit ballots to the Mississippi Secretary of State’s Office.  

When it appeared that the commissioners might be pushing the count to the 5 p.m. deadline to submit them to, Mississippi Supreme Court Central District candidate and State Sen. Jenifer Branning’s attorney Spencer Ritchie filed a lawsuit in Hinds County Circuit Court to pressure them into finishing on time, he said.

Branning, a Republican from Philadelphia, has been on the record saying she is a constitutional conservative and would not “legislate from the bench. She has also been endorsed by the Mississippi GOP.  

MSOS Communications Director Elizabeth Jonson confirmed after 6 p.m. on Nov. 15 that Hinds County had sent in its finalized results. The lawsuit was then dismissed, Ritchie told the Clarion Ledger in a text message.  

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Grant McLaughlin covers the Legislature state government for the Clarion Ledger. He can be reached at gmclaughlin@gannett.com or 972-571-2335 



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Moments that mattered in Mississippi State’s loss to No. 23 Missouri

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Moments that mattered in Mississippi State’s loss to No. 23 Missouri


STARKVILLE — Mississippi State’s defense came to play early in Saturday’s game against Missouri, but as has frequently been the case when Coleman Hutzler’s unit has a rare bright moment, the offense could not take advantage.

The No. 23 Tigers were backed up inside their own 10-yard line following a 48-yard Nick Barr-Mira punt, and then the Bulldogs’ defense delivered three straight big plays. Safety Hunter Washington violently broke up a screen pass on first down, linebacker Stone Blanton tripped up running back Nate Noel for a loss on second down, and after Isaac Smith brought the first wave of pressure on third down, Zakari Tillman sacked Brady Cook just outside the end zone.

With limited space for the snap, the ensuing Missouri punt traveled just 39 yards, and Kevin Coleman’s return gave MSU the ball at the Tigers’ 32. But on second-and-8, freshman quarterback Michael Van Buren faked a handoff to Davon Booth and faced pressure from Eddie Kelly Jr. as he surveyed his options downfield. He stumbled as he tried to step up in the pocket, leaving the ball dangling in his right hand as he tried to stay on his feet.

Defensive tackle Kristian Williams knocked the ball out, and before anyone in maroon realized what was happening, safety Daylan Carnell scooped it up in stride and took it back 68 yards for a touchdown without any Bulldog laying a hand on him.

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MSU never recovered from the shock to its system, and Missouri went on to win 39-20.

“That was rough,” center Ethan Miner said. “Those situations happen, and it’s human instinct when something goes wrong, you want to get down. You can’t allow yourself to do it. You have to keep pushing. That’s what happens in life. That’s what happens in this game. Adversity is going to strike. How are you going to respond?”

Burden’s impressive catch underscores Tigers’ third-down success

The Bulldogs (2-9, 0-7 Southeastern Conference) trailed by just four points after a quarter, but the Tigers (8-3, 4-3) extended their first drive of the second quarter when Cook evaded a would-be sack from Branden Jennings and scrambled to move the chains on third down. Missouri kept moving on the ground until Sulaiman Kpaka burst into the backfield to bring down running back Nate Noel for a four-yard loss, bringing up a third-and-9 at the MSU 28.

Cook rolled to his right and flung the ball on the run toward the end zone, where star receiver Luther Burden III was tightly covered by safety Corey Ellington. But Ellington never turned back to the ball, and Burden made a last-second adjustment to separate himself from the defensive back and bring the ball in as he went to the ground. The Bulldogs never again trimmed the deficit to one score.

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The Tigers finished 11-for-18 on third down and 2-for-2 on fourth down, and their average yards to go on third down was just 4.6. Missouri was a perfect 6-for-6 on medium-distance third downs (between five and eight yards).

“That’s just a play. (Burden) made a play,” said Blanton, who had a game-high 18 tackles. “Can’t hang our heads too hard on that. Other stuff, we have to be able to get off the field on.”

Fourth-down stop effectively ices game

Despite possessing the ball for less than four minutes in the second half, MSU pulled back within striking distance on Booth’s 43-yard touchdown run in the third quarter. After a missed field goal from Missouri, the Bulldogs were poised to get even closer, starting their next drive with a 49-yard deep ball from Van Buren to Kelly Akharaiyi.

On the second play of the fourth quarter, MSU faced a fourth-and-3 at the Tigers’ 17. Instead of kicking a field goal to get within one score, head coach Jeff Lebby kept his offense on the field, and Van Buren made a simple two-step drop and had Mosley open across the middle. But his throw was too low, and Mosley couldn’t quite reach down far enough to gather the ball in.

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The Tigers proceeded to take almost nine minutes off the clock before Marcus Carroll put the final nail in the coffin with his third touchdown run of the game.

“We’re down 11, we have a chance on fourth-and-3,” Lebby said. “We’re being aggressive. The book (says) go all the way, I’m going for it, and we have to make that layup. That’s truly a layup where we have the ability to pitch and catch.”

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Snap Counts from Mizzou at Mississippi State, Season Tracker

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Snap Counts from Mizzou at Mississippi State, Season Tracker


The Missouri offense was on the field for over two thirds of the No. 23-ranked Tigers’ victory over Mississippi State in Week 13, possessing the ball for 41 minutes and 51 seconds.

The Missouri offense played 79 snaps in the win, tying its previous high in snaps in SEC play from when the Tigers won over Vanderbilt in double overtime.

The full snap counts for both sides of the ball for Missouri revealed some interesting lineup moves. Here’s the full counts found on Pro Football Focus.

Offense

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LG Cayden Green, 79, 100%
RT Armand Membou, 79, 100%
C Drake Heismeyer, 79, 100%
QB Brady Cook, 79, 100%
LT Marcus Bryant, 79, 100%
RG Cam’Ron Johnson, 79, 100%
TE Jordon Harris, 57, 72%
TE Brett Norfleet, 53, 67%
WR Joshua Manning, 49, 62%
WR Theo Wease Jr., 45, 57%
WR Luther Burden III, 38, 48%
HB Nate Noel, 37, 47%
WR Marquis Johnson, 33, 42%
WR Mekhi Miller, 26, 33%
HB Marcus Carroll, 21, 27%
HB Jamal Roberts, 20, 25%
LG Mitchell Walters, 9, 11%
WR Daniel Blood, 5, 6%
HB Kewan Lacy, 1, 1%
TE Tyler Stephens, 1, 1%

• Interesting to see Joshua Mannig get more snaps than any other wide receiver. The coaching staff have praised his run blocking ability before though, which was what he did on 35 of his snaps.

• Pretty impressive for Marcus Carroll to score three touchdowns while only playing 27% of snaps

Defense

CB Dreyden Norwood, 50, 100%
S Daylan Carnell, 47, 94%
LB Triston Newson, 45, 90%
S Joseph Charleston, 43, 86%
CB Toriano Pride Jr., 41, 82%
ED Johnny Walker Jr., 40, 80%
ED Zion Young, 35, 70%
LB Corey Flagg, 33, 66%
DL Kristian Williams, 33, 66%
S Caleb Flagg, 27, 54%
DL Chris McClellan, 27, 54%
DL Sterling Webb, 27, 54%
S Marvin Burks Jr., 23, 46%
LB Chuck Hicks, 22, 44%
DL Eddie Kelly Jr., 17, 34%
CB Nicholas Deloach Jr., 15, 30%
ED Jahkai Lang, 12, 24%
S Tre’Vez Johnson, 11, 22%
DL Marquis Gracial, 8, 16%
DL Jalen Marshall, 7, 14%
S Sidney Williams, 7, 14%
LB Nicholas Rodriguez, 2, 4%

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• Nicholas Deloach Jr. was the more relied upon corner opposite of Dreydon Norwood for each of the past two games, but Toriano Pride Jr. stepped back into that role in this one.

• With Tre’Vez Johnson dealing with some sort of injury, Caleb Flagg saw some more playing time at safety.

Offense

LT Marcus Bryant, 764, 100%
RT Armand Membou, 756, 99%
RG Cam’Ron Johnson, 679, 89%
LG Cayden Green, 673, 88%
QB Brady Cook, 602, 79%
C Connor Tollison, 582, 76%
WR Theo Wease Jr., 566, 74%
WR Luther Burden III, 492, 64%
TE Brett Norfleet, 359, 47%
TE Jordon Harris, 331, 43%
WR Joshua Manning, 329, 43%
WR Mookie Cooper, 328, 43%
HB Nate Noel, 323, 42%
WR Mekhi Miller, 313, 41%
G Mitchell Walters, 265, 34%
HB Marcus Carroll, 239, 31%
C Drake Heismeyer, 232, 30%
WR Marquis Johnson, 223, 29%
QB Drew Pyne, 217, 28%
HB Jamal Roberts, 193, 25%
TE Tyler Stephens, 126, 17%
WR Daniel Blood, 119, 16%
T Jayven Richardson, 57, 7%
G Logan Reichert, 56, 7%
G Tristan Wilson, 49, 6%
HB Kewan Lacy, 43, 5%
G Curtis Peagler, 26, 3%
HB Tavorus Jones, 24, 3%
TE Jude James, 21, 3%
WR James Madison II, 13, 2%
WR Courtney Crutchfield, 10, 1%
WR Logan Muckey, 8, 1%
C Talan Chandler, 7, 1%
TE Whit Hafer, 3, 0%
QB JR Blood, 2, 0%

Defense

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CB Dreyden Norwood, 517, 79%
S Marvin Burks Jr., 475, 73%
S Daylan Carnell, 465, 71%
ED Johnny Walker Jr., 445, 68%
CB Toriano Pride Jr., 438, 67%
DL Kristian Williams, 401, 61%
ED Zion Young, 397, 61%
S Joseph Charleston, 384, 59%
LB Triston Newson, 380, 58%
DL Chris McClellan, 370, 57%
LB Corey Flagg, 345, 53%
CB Nicholas Deloach Jr., 313, 48%
S Tre’Vez Johnson, 269, 41%
LB Chuck Hicks, 258, 39%
DL Sterling Webb, 236, 36%
S Sidney Williams, 236, 36%
DL Eddie Kelly Jr., 223, 34%
LB Khalil Jacobs, 223, 34%
ED Jahkai Lang, 185, 28%
DL Marquis Gracial, 139, 21%
S Caleb Flagg, 124, 19%
DL Jalen Marshall, 114, 17%
ED Joe Moore, 105, 16%
LB Nicholas Rodriguez, 103, 16%
DL Sam Williams, 49, 8%
CB Marcus Clarke, 44, 7%
ED Williams Nwaneri, 38, 6%
S Jaylen Brown, 37, 6%
S Trajen Greco, 36, 6%
DB Shamar McNeil, 32, 5%
LB Jeremiah Beasley, 28, 4%
DB Phillip Roche, 24, 4%
DB Ja’Marion Wayne, 22, 3%
DL Elias Williams, 11, 2%
LB Brayshawn Littlejohn, 11, 2%
LB Brian Huff, 8, 1%
CB Jaren Sensabaugh, 6, 1%
CB Justin Bodford, 6, 1%
CB Cameron Keys, 6, 1%
CB Nasir Pogue, 6, 1%
LB Brady Hultman, 2, 0%
LB Will Norris, 1, 0%



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