Surprise medical billing gets increased industry lobbying

January 28, 2019, Modern Healthcare, Susannah Luthi -  The debate over federal curbs on surprise medical bills has it all: inter-industry finger-pointing, slippery-slope warnings about rate-setting and dueling narratives about what the problem is. Last week President Donald Trump invited people who have been hit with surprise bills to the White House, where he vowed to end the practice that puts patients on the hook for the often exorbitant price tag of out-of-network treatment. The issue is a political winner. Senate offices are wrangling over the legislative mechanics of tackling surprise bills, and insurers and providers are clashing over who needs to concede more. Insurers frame the problem as one of surprise medical billing; providers as surprise gaps in coverage.

Insurance proposal could shift pay burden on ER visits

January 27, 2019, Daily Journal, Michaela Gibson Morris-  A group of emergency physicians is sounding alarms, but Blue Cross says there’s no fire. The state and national chapters of the American College of Emergency Physicians are taking issue with Blue Cross & Blue Shield of Mississippi, saying a proposed policy will decide the severity of medical emergencies after the fact and leave hospitals, doctors and patients on the hook for uncovered expenses. “Health insurance companies can’t expect patients to know which symptoms are life-threatening,” said Dr. Philip Levin, president of the Mississippi chapter of the American College of Emergency Physicians. At issue is a bulletin sent in December by Blue Cross & Blue Shield of Mississippi to network providers. The Blue Cross update noted that in 2019, the insurer would be monitoring and evaluating how emergency visits were coded for severity and ensuring they were aligned with the severity of the diagnosis code submitted.

Mississippi Medicaid won’t seek midyear infusion of money

January 23, 2019, Sun Herald, Emily Wagster Pettus, Associated Press-  Mississippi’s Medicaid director said Wednesday that the program will not seek additional money for the final half of the state budget year. This is the first time that has happened in the past five years. Director Drew Snyder told lawmakers that enrollment has decreased, accounting for some savings. The current budget year ends June 30. Snyder said the Division of Medicaid is requesting a modest funding increase of about 2 percent for the year that begins July 1 - less than the cost of health care is rising nationwide. Many of Mississippi’s rural hospitals have struggled in recent years, and health advocates say expanding Medicaid could help alleviate some of those financial problems by reducing the number of uninsured residents. Roy Mitchell, executive director of the Mississippi Health Advocacy Program, listened to Snyder’s presentation Wednesday and came away optimistic that the Bryant administration is softening its position. “If the governor’s going to step out of the way and let the Legislature decide this, let it be,” Mitchell told reporters after the committee meeting. “That’s very encouraging to hear that from the director of Medicaid.


January 25, 2019, MPB, Desare Frazier- Legislators and healthcare advocates are meeting with the executive director of the Mississippi Division of Medicaid to learn more about it’s budget. Director Drew Snyder says enrollment has declined, saving some money. That means no budget shortfall this year. Federal and state dollars fund the health insurance program, which received $5.85 billion last year according to their financial report. When the question turned to Medicaid expansion Snyder said, “Medicaid expansion is not on our agenda in any way and we’re focused on responsibly providing access to quality care for beneficiaries and better value to the tax payer,” said Snyder.  Snyder said expanding Medicaid is up to the legislature. Roy Mitchell of Mississippi Health Advocacy took that as a hopeful sign. He says Governor Phil Bryant has opposed the move. Mitchell says maybe he’s stepping back from the issue.  “Every poll says the majority of Mississippians support Medicaid expansion. The most recent said 3 out of 5 Mississippians support Medicaid expansion. So, if the governor is going to step out of the way and let the legislature decide this let it be,” said Mitchell.

Medicaid hearing takes place at Capital; addresses “elephant in the room”

January 23, 2019, WLOX, Nick Ducote- Mississippi Executive Director of Medicaid, Drew Snyder, briefed members of the House of Representatives and gave them an update on the current status of the program. The big issue at hand - whether the state should “expand.” “Look, I’ll go ahead and address the elephant in the room head on,” said Snyder. “Obviously the issue of Medicaid expansion is a very hot topic right now. And there are strong opinions for and against it, and many of these strong opinions are right here in this room.” According to Snyder, the agency has been able to find ways to find cost savings. So they’re not asking lawmakers this year for as much as they have in the past. For the 2020 fiscal year, the budget request to the Joint Legislative Budget Committee originally asked for $954 million, but on Jan. 14th 2019, they revised the budget to $939 million. State Democrats say small and rural hospitals are shouldering the burden of the costs by treating high numbers of uninsured patients.

Analysis: Pulling Back Curtain On Hospital Prices Adds New Wrinkle In Cost Control

January 28, 2019, KHN, Elisabeth Rosenthal - As President Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game changer for health care. Starting this month, hospitals must publicly reveal the contents of their master price lists - called “chargemasters” - online. These are the prices that most patients never notice because their insurers negotiate them down or they appear buried as line items on hospital bills. What has long been shrouded in darkness is now being thrown into the light. For the moment, these lists won’t seem very useful to the average patient - and they have been criticized for that reason. They are often hundreds of pages long, filled with medical codes and abbreviations. Each document is an overwhelming compendium listing a rack rate for every little item a hospital dispenses and every service it performs: a blood test for anemia. The price of lying in the operating suite and recovery room (billed in 15-minute intervals). The scalpel. The drill bit. The bag of IV salt water. The Tylenol pill. No item is too small to be bar coded and charged.