United drops Ala. hospitals from Miss. Medicaid, children's plans. 1,000 families affected

USA officials said United's move caught them by surprise and could force patients on the Coast to drive two and a half hours to Jackson.

Geoff Pender
Mississippi Clarion Ledger

United Health Care is dropping University of South Alabama hospitals from its Mississippi Medicaid managed care and children's plans, a move that affects about 1,000 patients in South Mississippi.

USA officials said United's move caught them by surprise and could force patients on the Mississippi Coast to drive two and a half hours to Jackson for similar services instead of 45 minutes to Mobile. Medicaid officials said those on United's plans still have time to apply for others that cover USA Health.

Many patients on United's MississippiCAN and Mississippi Children's Health Insurance Program plans for Medicaid from Harrison, Jackson, George and Stone counties use USA Health's Medical Center and Children's and Women's hospitals in Mobile. USA has the area's only academic hospital, level 1 trauma center, level 4 neonatal intensive care and other services.

United Health is dropping University of South Alabama hospitals from its Mississippi Medicaid managed care plan, a move that would affect about 1,000 patients from South Mississippi.

OPEN ENROLLMENT:MississippiCAN Medicaid enrollment is open through Dec. 15

USA removal is effective Dec. 15

Chris Jett, administrator for USA Health Children's and Women's Hospital, said United recently notified USA it was being dropped from the network in a letter, with little explanation. The removal is effective Dec. 15.

"They dropped us as a provider and unfortunately didn't give any details, or a reason," Jett said. "They gave us a 1-800 number to call. We have asked for a response, but they have not provided any details."

Jett said the move means many patients on the Coast would have to go to the University of Mississippi Medical Center in Jackson for equivalent services.

"How we live on the Coast — go to eat in Biloxi and Pascagoula, go shop in Mobile — we live across the (state) borders," Jett said. "It's the same way with health care ... A 45-minute drive is a lot different than a two-and-a-half hour drive. USA Health has the only level 1 trauma, only level 4 neonatal intensive care, the only burn center."

United is one of three insurers offering Medicaid managed care plans, and one of two providing CHIP programs covering children. Magnolia Health and Molina Healthcare will continue with USA in network for their managed care plans and Magnolia will continue with USA in network for CHIP. Medicaid officials said they know of no plans for Molina or Magnolia to drop the Alabama hospitals.

Enrollment is open for people to apply to switch to Molina or Magnolia for MississippiCAN or Mississippi CHIP now through Dec. 15.

United Health Care issues statement bout USA decision

United in a written statement to the Clarion Ledger said its focus is "on ensuring the long-term strength and stability of our Community Plan in Mississippi" and "we continuously monitor the performance of our network providers and occasionally make changes."

United said: 

  • Our Community Plan members will continue to have access to a robust network of hospitals and physicians that participate in our Mississippi CHIP and MississippiCAN networks, including the University Children’s Hospital in Jackson, the University of Mississippi Medical Center, St. Dominic Memorial Hospital, CHS Merit Health and Baptist Medical Center.
  • United Health Care members in active treatment at a University of South Alabama facility or with a South Alabama physician may be able to continue receiving covered services even after the contract expires through our Continuity of Care program. Members who are pregnant or undergoing active treatment for a serious medical condition such as cancer may qualify. United Health Care members should call the number on their health plan ID card to see if they qualify for Continuity of Care.
  • The University of South Alabama remains in our network for our members enrolled in employer-sponsored and Medicare Advantage plans.

 

Mississippi Medicaid Director Drew Snyder said the agency's position on the issue is, "that it's a contractual matter between the insurer and the hospital and we're not going to interfere with their contractual negotiations or lack thereof."

"We're going to ensure that our members have an adequate network and access to quality care," Snyder said. "I'm not worried at all about network adequacy. I'm not worried at all that the University of South Alabama leaving United's network would threaten network adequacy."

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Contact Geoff Pender at 601-961-7266 or gpender@gannett.com. Follow him on Twitter.