JACKSON, Miss. (AP) — Two hospitals in Mississippi are ending Medicare Advantage agreements, state Insurance Commissioner Mike Chaney said Monday.
The changes will force patients to travel elsewhere for care or seek other coverage before a Dec. 7 deadline for Medicare enrollment.
"The underlying issue is that health providers, whether doctors or hospitals, are demanding more payment for their services rendered to those on Medicare, and the Medicare Advantage plans are refusing to pay more," Chaney told the Clarion Ledger .
North Mississippi Health Services, which includes North Mississippi Medical Center in Tupelo, is ending its network agreement with Humana Medicare Advantage plans at the end of the year. This affects 4,500 patients. Chaney said in a news release that alternative in-network hospitals in northern Mississippi include Baptist Memorial Hospital, which has several facilities; OCH Regional Medical Center in Starkville; and Trace Regional Hospital in Houston.
Southwest Health System in Pike County is ending its agreement with Wellcare Medicare Advantage, which covers 800 patients. Chaney said Wellcare patients may go to other in-network hospitals in southwestern Mississippi, including King's Daughters Medical Center in Brookhaven, Walthall County General Hospital and Marion General Hospital.
Medicare Advantage is a managed-care plan. For patients remaining in network, it offers reduced out-of-pocket expenses and more coverage, including dental.
Hospitals around the U.S. complain that Medicare Advantage providers routinely deny payment for services, driving up administrative costs for appealing the denials. Insurance providers say doctors and hospitals try to charge too much or prescribe unwarranted expensive medications and procedures.
People can go to www.mid.ms.gov to look at Medicare plans and consumer guides. Chaney said his agency has little control over federal Medicare or Advantage plans, but said he tries to "intervene when it impacts consumers."